Command hospital doctors perform rare surgery to treat Pierre Robin sequence in newborn

PRS is one such rare disorder where the lower jaw is very small, along with cleft of the palate, allowing for uncomfortable breathing of the child. Children with such critical birth conditions rarely make it to their first birthday if not treated promptly. 

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PRS affects one in 60,000 live births. They develop pneumonia and other respiratory conditions, which makes survival difficult.

The hospital saw one such case that was transferred from a primary hospital to the Command hospital in Lucknow.

This newly born child had difficulty in breathing and manifested difficulty to thrive.

A team of specialists headed by Brig M. K. Rath, Consultant Maxillofacial surgery and Colonel Ashutosh (Neonatologist), Colonel Badal Parikh (Anaesthesiologists) and Lt Colonel Vishal Kulkarni (Maxillofacial Surgery) jointly evaluated the baby.

As the child was having relatively lesser weight and an underdeveloped lower jaw, a lip-tongue adhesion surgery was performed as an interim measure. Once the child was fit for major surgery, she was managed for placement of distractor (instruments used to move the lower jaw ahead). State-of-the-art video-guided intubation was resorted to by the anaesthesiologists.

The baby's small lower jaw was lengthened by over 10 mm by using the latest surgical technique called neonatal distraction histiogenesis.

This novel surgical technique was developed by the Russian Military Surgeon Gavriil Ilizarov to lengthen the amputated limbs of Russian Soldiers.

The technique has been successfully adapted by maxillofacial surgeons to lengthen the human jaws. The technique involves creating fracture on both sides of the jaw, intentionally allowing to heal for 4-5 days and gradually separating the jaws segments by stretching the healing tissue, thus harnessing the inherent biological potential.

The lengthening of the lower jaw moved the tongue forward and opened the collapsed upper airway, thus helping the baby to breath normally.

The baby was weaned off all artificial respirators and discharged from the hospital after 61 days of stay and is now on road to full recovery.

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