Placement of a Supraglottic Airway to Overcome Airway Obstruction When Performing Nasal Fiberoptic Intubation in Infants With Pierre Robin Sequence: A Case Series

2020 ◽  
Vol 14 (11) ◽  
pp. e01302
Author(s):  
Mitchell Phillips ◽  
Narasimhan Jagannathan
Keyword(s):  
Airway Obstruction ◽  
Case Series ◽  
Supraglottic Airway ◽  
Fiberoptic Intubation ◽  
Pierre Robin Sequence ◽  
Robin Sequence ◽  
Pierre Robin

A Systematic Review of Mandibular Distraction Osteogenesis Versus Orthodontic Airway Plate for Airway Obstruction Treatment in Pierre Robin Sequence

2021 ◽  
pp. 105566562110118
Author(s):  
Darren B. Abbas ◽  
Christopher Lavin ◽  
Evan J. Fahy ◽  
HyeRan Choo ◽  
Mai Thy Truong ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Distraction Osteogenesis ◽  
Literature Search ◽  
Oral Feeding ◽  
Treatment Modalities ◽  
Pierre Robin Sequence ◽  
Mandibular Distraction ◽  
Robin Sequence ◽  
Mandibular Distraction Osteogenesis ◽  
Pierre Robin

Objective: Mandibular distraction osteogenesis (MDO) is frequently performed to address airway obstruction in patients with Pierre Robin sequence (PRS), though more recently the technique of orthodontic airway plating (OAP) has gained traction. We aimed to evaluate OAP compared to MDO for airway obstruction in PRS. Design: A systematic literature search across PubMed, Embase, and Google Scholar identified all studies published in English, which involved MDO or any form of OAP as treatments for PRS. All relevant articles were reviewed in detail and reported on, adhering to PRISMA guidelines. Main Outcome Measures: Airway (tracheostomy avoidance, decannulation rate), feeding (full oral feeding tolerance). Results: Literature search identified 970 articles, of which 42 MDO studies and 9 OAP studies met criteria for review. A total of 1159 individuals were treated with MDO, and 322 individuals were treated with OAP. Primary outcomes appear similar for MDO and OAP at face value; however, this must be interpreted with different pretreatment contexts in mind. Conclusions: Orthodontic airway plating may be considered for airway obstruction in PRS, as some airway-related and feeding-related outcomes appear similar with MDO, per existing evidence in the literature. However, since PRS severity differed between studies, OAP cannot be uniformly considered a replacement for MDO. Further research is required to more comprehensively assess these treatment modalities inclusive of metrics that allow for direct comparison.

Quantification of Mandibular Morphology in Pierre Robin Sequence to Optimize Mandibular Distraction Osteogenesis

2020 ◽  
Vol 57 (8) ◽  
pp. 1032-1040 ◽  
Author(s):  
Angela S. Volk ◽  
Matthew J. Davis ◽  
Amit M. Narawane ◽  
Amjed Abu-Ghname ◽  
Robert F. Dempsey ◽  
...  
Keyword(s):  
Airway Management ◽  
Airway Obstruction ◽  
Distraction Osteogenesis ◽  
Pierre Robin Sequence ◽  
Management Decisions ◽  
Mandibular Distraction ◽  
Robin Sequence ◽  
Mandibular Distraction Osteogenesis ◽  
Mandibular Body ◽  
Pierre Robin

Background: Mandibular distraction osteogenesis (MDO) is the primary surgical intervention to treat airway obstruction in Pierre Robin sequence (PRS). Current morphologic studies of PRS mandibles do not translate into providing airway management decisions. We compare mandibles of infants with nonsyndromic PRS to controls characterizing morphological variances relevant to distraction. We also examine how morphologic measurements and airway grades correlate with airway management. Methods: Patients with PRS under 2 months old were age and sex matched to controls. Demographic and perioperative data, and Cormack-Lehane airway grades were recorded. Computed tomography scans were used to generate mandibular models. Bilateral condylions, gonions, and the menton were identified. Linear and angular measurements were made. Wilcoxon rank sum and 2-sample t tests were performed. Results: Twenty-four patients with PRS and 24 controls were included. Seventeen patients with PRS required MDO. PRS patients had shorter ramus heights (16.7 vs 17.3 mm; P = .346) and mandibular body lengths (35.3 vs 39.3 mm; P < .001), more acute gonial angles (125.3° vs 131.3°; P < .001), and more obtuse intergonial angles (94.2° vs 80.4°; P < .001) compared to controls. No significant differences were found among patients requiring MDO versus conservative management nor among distracted patients with high versus low airway grades. Conclusion: Our study examines the largest and youngest PRS population to date regarding management of early airway obstruction with MDO. Our findings indicate that univector mandibular body distraction allows for normalization in nonsyndromic patients with PRS, and airway obstruction management decisions should remain clinical.

scholarly journals Management of Airway Obstruction in Infants With Pierre Robin Sequence

2018 ◽  
Vol 6 (5) ◽  
pp. e1688 ◽  
Author(s):  
Christopher M. Runyan ◽  
Armando Uribe-Rivera ◽  
Shahryar Tork ◽  
Tasneem A. Shikary ◽  
Zarmina Ehsan ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Pierre Robin Sequence ◽  
Robin Sequence ◽  
Pierre Robin
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