Resolving Feeding Difficulties With Early Airway Intervention in Pierre Robin Sequence

Abstract

In children with iPRS, feeding difficulties can be resolved with early airway intervention. Delaying airway intervention may necessitate feeding assistance because all of the iPRS children who required a g-tube fell into this category. The presence of additional disorders and syndromes further complicates treatment because most of the sPRS children required g-tubes regardless of airway intervention.

Semi-Automatic Volumetric Segmentation of the Upper Airways in Patients with Pierre Robin Sequence

“…Major controversy exists on what to do in the remaining 20% of patients with PRS. In addition, we cannot forget the morbidity and mortality rate of tracheostomy in infants [13][14][15] . The possibility to measure upper airway volume to choose patients eligible for surgery could be decisive for patients' outcome.…”

“…17 , floor-of-mouth release 18 , and distraction osteogenesis 19 . All these procedures have a severe impact on everyday life and significant morbidity 13 . In making a treatment decision a precise assessment of upper airway patency is crucial to avoid spontaneous desaturation or asphyxiation episodes during feeding and sleeping.…”

“…The assessment of the impairment is based on clinical parameters (episode of desaturation, spontaneously and during feeding and sleep) and growth of facial structures during the first two years of life [9][10][11][12] . Many clinicians suggest treating mild cases with prone positioning using special "sniffing air" beds or other non-invasive respiratory support 13 . In cases of severe respiratory impairment surgery is required 14 .…”

Robin Sequence: From Diagnosis to Development of an Effective Management Plan

“…Although early airway intervention was associated with decreased need for gastrostomy tube placement in 1 study, feeding issues or weight loss as an indication for surgical airway intervention have not been universally accepted. 90 …”

Avaliação da dificuldade respiratória na sequência de Robin: estudo clínico e polissonográfico

“…As dificuldades alimentares: disfagia, vômitos, aspiração, são usualmente secundárias à obstrução de vias aéreas e são agravadas pela fissura de palato (LIDSKY; LANDER; SIDMAN, 2008 A desvantagem do tratamento descrito por eles foi a longa permanência hospitalar. Assim, novos protocolos para tratamento domiciliar com INF foram estabelecidos, visando manter a mesma eficácia e segurança e ainda alta hospitalar mais precoce (HEAF et al, 1982;OLSON et al,1990;MONDINI et al, 2009 et al (2003).…”