Respiratory management of Pierre Robin sequence using nasopharyngeal airway with Kirschner wire

Logistic regression analysis of Pierre Robin sequence patients requiring surgical intervention

“…Treatment of PRS TBAO has been attempted with different modalities including positioning, NPA, TLA, perimandibular wires with traction, and tube gauze head suspension . Many of these treatments have fallen out of favor; however, the NPA continues to be a mainstay.…”

“…Pierre Robin sequence (PRS) is the combination of cleft palate, glossoptosis, and micrognathia, which leads to tongue‐based airway obstruction (TBAO) . Initial clinical management of PRS includes multiple nonsurgical treatment modalities including positioning, passive mandibular displacement, and nasopharyngeal airway placement . Failure of these measures, or instability of the airway, requires surgical intervention to stabilize the airway.…”

“…The surgical approach to TBAO has evolved from perimandibular wiring and tube gauze to more common procedures including tracheotomy and tongue‐lip adhesion (TLA) . Mandibular distraction osteogenesis (MDO) to address TBAO has been used; however, there is regionalization of care based on geography and provider subspecialty .…”

Percutaneous Dilational Tracheotomy for Airway Management in a Newborn With Pierre-Robin Syndrome and a Glossopharyngeal Web

“…1,13 Previous reports have described several techniques for airway management in patients with PRS. 2,[6][7][8][14][15][16] Nevertheless, during our literature review we could not find any report on the use of PDT for airway management in patients with PRS. The use of PDT for emergency airway management in a newborn is highly controversial.…”

“…1 Children with PRS may present with airway obstruction, which, without appropriate respiratory management, can result in death. 2 Evans and coworkers 3 have reported that in a series of 115 patients with PRS the incidence of airway problems that required an intervention was 44%. In another retrospective study of 110 children with PRS, prone posturing alone effectively relieved the mild airway obstruction in 82 patients; however, in 28 infants with severe respiratory distress, endotracheal intubation was required.…”