Children with craniofacial abnormalities associated with retromicrognathia and glossoptosis often have compromised upper airway flow. In severe cases, emergency intubation is necessary immediately after birth, and tracheostomy is advocated to manage the airway in the neonatal period and to allow for feeding. Early intervention with bilateral mandibular osteogenesis avoids the need for tracheostomy, along with its complications, and it targets the primary etiologic factor of the problem—the anomalous anatomy of the mandible. We report two neonates with severe Pierre Robin sequence managed with bilateral mandibular distraction osteogenesis on day 9 and day 11 of life. The surgical techniques and distraction and consolidation periods were similar apart from the distraction devices used. The procedures were successful with early extubation (day 5 and day 7), oral feeding tolerance (day 11 and day 13) and hospital discharge (day 19 and day 18). Total mandibular distraction was 19 mm and 23.45 mm, respectively. No major complications were reported. Medium to long-term results were good. Bilateral mandibular distraction osteogenesis in the neonate is a safe and accurate procedure and is the primary option in cases of selected severe Pierre Robin sequence.
Skin type classification is important because it provides guidance for professionals and consumers to recommend and select the most appropriate cosmetic products and skin care protocols and it is also important in clinical research. Several methods have been proposed for classifying skin typologies such as non-invasive bioengineering tools (examples: Corneometer® and Sebumeter®), visual and tactile methods (subjective methods that evaluate skin appearance, texture, temperature, and abnormalities), artificial intelligence-based tools and instruments (examples: visual rating scales, and self-report instruments). Examples of known visual rating scales used to classify skin aging are the Griffiths Photonumeric Scale, the Glogau Scale, and the SCINEXA Scale. The Fitzpatrick Skin Phototype Classification and the Baumann Skin Type System are some of the self-report instruments used for skin type classification. Despite the diversity of methods to classify skin type and degree of skin aging, data on instruments are scarce and not adequately compiled. Validation in larger samples and with individuals of different ethnicities and geographic locations is needed to promote a more universal use. Visual rating scales and instruments are interesting tools that allow the skin to be promptly and efficiently examined, without using costly or complex equipment, and are very useful in a clinical or self-assessment context.
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