Subperiosteal Release of the Floor of the Mouth in Pierre Robin Sequence: Experience with 12 Cases

1996 ◽  
Vol 33 (6) ◽  
pp. 468-472 ◽  
Author(s):  
Louise Caouette-Laberge ◽  
Caroline Plamondon ◽  
Yvan Larocque
Keyword(s):  
Upper Airway ◽  
Oral Intake ◽  
Pierre Robin Sequence ◽  
Feeding Difficulties ◽  
Floor Of The Mouth ◽  
Robin Sequence ◽  
Group 2 ◽  
Systemic Antibiotics ◽  
Pierre Robin ◽  
Group 1

Between 1983 and 1995, 12 children with Pierre Robin sequence were treated with a subperiosteal release of the floor of the mouth (SRFM) to correct severe upper-airway obstruction (group 1: n = 10) and prolonged feeding difficulties (group 2: n = 2). Eight children had isolated Pierre Robin sequence, while four had associated anomalies. The age at surgery was 2 to 13 weeks (mean, 5.2 wk) in group 1, and 8.5 months to 5 years in group 2. Postoperative endotracheal intubation was maintained for 1 to 14 days, and nasopharyngeal intubation for 3 to 13 days. One child with a tracheostomy prior to SRFM was decanulated 11 weeks postoperatively. Postoperative course was uneventful and control polysomnograms (group 1) showed a marked improvement of the obstructive phenomenons and O2 saturation levels. Children were discharged 2 to 6 weeks postoperatively (mean, 4 wk) except for the child with a tracheostomy (19 wk). The only complication was a wound infection treated with systemic antibiotics. Oral feedings were initiated shortly after extubation: six children were discharged with oral feedings only, one child required supplemental gavages for 6 weeks at home, and three children had persistent inadequate oral intake. We have found SRFM to be an effective surgical procedure for the management of infants with Pierre Robin sequence.

Management of upper airway obstruction in Pierre Robin sequence

1997 ◽  
Vol 111 (12) ◽  
pp. 1155-1156 ◽  
Author(s):  
A. P. Bath ◽  
P. D. Bull
Keyword(s):  
Airway Obstruction ◽  
Surgical Intervention ◽  
Neonatal Period ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Pierre Robin Sequence ◽  
Severe Respiratory Distress ◽  
Feeding Difficulties ◽  
Robin Sequence ◽  
Pierre Robin

AbstractPierre Robin sequence (PRS) presents in the neonatal period with upper airway obstruction and feeding difficulties. Infants with pronounced micrognathia may fail to thrive because of chronic airway obstruction, or experience severe respiratory distress. This is potentially fatal and surgical intervention in these cases is necessary. We present our series of cases with severe PRS requiring surgical relief of their airway obstruction, and the reasons for preferring tracheostomy over glossopexy.

Management of Infants with Pierre Robin Sequence

2003 ◽  
Vol 40 (2) ◽  
pp. 180-185 ◽  
Author(s):  
Silke Wagener ◽  
Sukh S. Rayatt ◽  
Andy J. Tatman ◽  
Peter Gornall ◽  
Rona Slator
Keyword(s):  
Airway Obstruction ◽  
Outcome Measures ◽  
Nutritional Support ◽  
Upper Airway ◽  
Pierre Robin Sequence ◽  
Monitoring Methods ◽  
Feeding Difficulties ◽  
Robin Sequence ◽  
Nasopharyngeal Airway ◽  
Pierre Robin

Objective Several methods of treating babies with Pierre Robin sequence have been described since the condition itself was first documented in 1923. The main aim of treatment has been to relieve upper airway obstruction. Treatment methods used range from positioning of the baby to invasive surgery. The aim of this article was to describe the assessment, treatment, and monitoring methods used for babies referred with Pierre Robin sequence (PRS). Setting/Patients From December 1995 to May 2000, 22 consecutive patients were admitted to Birmingham Children's Hospital with PRS. Their airway and nutritional status were assessed and continuously monitored. Interventions Treatment concentrated on the relief of airway obstruction with a nasopharyngeal airway (NPA) and nutritional support of the babies until they grew out of their respiratory and feeding difficulties. Main Outcome Measures Outcome measures were oxygen saturation, growth of the babies, and the need for surgery. Results All babies were managed successfully with an NPA and nutritional support. No baby required surgery, and the majority showed good weight gain. Conclusion Relieving airway obstruction by NPA is an effective and safe treatment for babies with PRS until they have grown out of their respiratory and feeding difficulties. It avoids the need for surgery and can be used on neonatal wards using the monitoring described.

How Does Hypodontia Compare in Nonsyndromic Pierre Robin Sequence Versus Isolated Cleft Palate and Isolated Cleft Lip?

2021 ◽  
pp. 105566562110177
Author(s):  
Maria Dillon ◽  
Madhavi Seshu ◽  
Norah Flanigan ◽  
Susana Dominguez-Gonzalez
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Pierre Robin Sequence ◽  
Robin Sequence ◽  
Sequence Versus ◽  
Group 2 ◽  
Alder Hey ◽  
Isolated Cleft Palate ◽  
Pierre Robin ◽  
Group 1

Objective: To assess the prevalence and patterns of hypodontia in nonsyndromic Pierre Robin sequence (PRS) and compare it with hypodontia in nonsyndromic isolated cleft palates and isolated cleft lips. Design: Retrospective cohort study. Setting: Alder Hey Children’s Hospital, United Kingdom. Patients: Patients with nonsyndromic PRS (group 1), isolated cleft palate (group 2), and isolated cleft lip (group 3). Main Outcome Measures: Hypodontia in the permanent dentition assessed from orthopantomographs. Results: A total of 154 patients were included. Group 1 had the highest incidence of hypodontia with 47% having at least one tooth congenitally absent. Groups 2 and 3 had reduced rates of hypodontia with 27% and 19% of the groups missing teeth, respectively; 93% of cases of hypodontia in group 1 involved the absence of at least one second premolar. Of these patients, there was found to be bilateral agenesis of second premolars in 50% of cases. Conclusions: Patients with PRS and cleft palates are more likely to have hypodontia than those with isolated cleft palates or unilateral cleft lips. Patients with PRS have more severe hypodontia than those with isolated cleft palates or unilateral cleft lips. Bilateral agenesis of lower second premolars is a commonly seen pattern among patients with PRS. In this large UK study, a similar prevalence and pattern of hypodontia to other nonsyndromic PRS populations worldwide has been demonstrated.

Nasopharyngeal Tube and Functional Treatment in Pierre Robin Sequence: A Tertiary Clinical Experience From 150 Cases

2021 ◽  
pp. 105566562110311
Author(s):  
Fabian Blanc ◽  
Inge Harrewijn ◽  
Claire Duflos ◽  
Frederica Maggiulli ◽  
Guillaume Captier
Keyword(s):  
Oral Feeding ◽  
Pierre Robin Sequence ◽  
Robin Sequence ◽  
Initial Care ◽  
Nasopharyngeal Airway ◽  
Airway Tube ◽  
Group 3 ◽  
Group 2 ◽  
Pierre Robin ◽  
Group 1

Objectives: To describe the initial care practices for children with Pierre Robin sequence (PRS) and analyze the factors predicting the severity of the obstruction breathing disorders. Design: A retrospective single-center study of 150 children with PRS. Setting: Single tertiary care center, Regional Competence Center for the diagnosis and treatment of PRS. Patients: A total of 150 children with PRS consecutively followed between 1986 and 2017. Group 1 comprises children without specific respiratory management; group 2, children requiring prone positioning to alleviate their respiratory distress symptoms; and group 3, children requiring nasopharyngeal airway tube (NT) or nonconservative surgical treatment. Main outcome measures: Evolution and results of the initial treatment of PRS. Results: Forty-two percent (n = 63) were attributed to group 1, 39% (n = 50) to group 2, and 19% (n = 29) to group 3. Preterm birth, birth weight, or associated congenital malformations were not significantly different between the groups. However, the age of exclusive oral feeding was significantly different: 1 day (quartiles: 0-3) for group 1; 11 days (quartiles: 1-28) for group 2; 39 days (quartiles: 19-111) for group 3 ( P < .0001). Considering the NT, its use relieves the upper airway obstruction, assessed by a respiratory polygraphy, in 14 children. Conclusions: Nasopharyngeal airway tube has become our major first-line treatment, avoiding more complex procedures in most of the cases. The achievement of exclusive oral feeding seems to be a good predictor of the severity of respiratory symptoms in PRS.

scholarly journals 1173 Airway and Breathing Problems in Pierre Robin Sequence: A Systematic Review Protocol

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Ramjeeawon ◽  
P van der Plas ◽  
L van de Lande ◽  
J Ong ◽  
M Wyatt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Grey Literature ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Cochrane Central Register ◽  
Pierre Robin Sequence ◽  
Expert Opinions ◽  
Robin Sequence ◽  
Assessment And Monitoring ◽  
Pierre Robin

Abstract Aim The primary aim is to systematically review the specific airway and/or breathing problems which have been reported in Pierre Robin Sequence (PRS). Secondary aims are to understand the prevalence and severity of these airway and breathing problems, and options for screening, assessment, and monitoring. Method A search strategy will be designed to search the following databases: MEDLINE, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials(CENTRAL) including a grey literature search, to identify publications on airway and/or breathing problems in Pierre Robin Sequence patients. Airway or breathing problems to be included are defined upper airway conditions (e.g., sleep apnoea) or clinically or objectively defined airway/breathing problems (e.g., increased respiratory rate, polysomnography). Screening will exclude non-English articles, abstracts, letters, editorials, expert opinions and breathing problems not anatomically related to craniofacial underdevelopment. Results This systematic review has been successfully registered on the PROSPERO International Prospective Register of Systematic Reviews (CRD42020210572) Conclusions PRS is a rare craniofacial condition which presents at birth, consisting of micrognathia, glossoptosis and airway problems, and is usually, but not always, associated with a cleft palate. There is no consensus on the type of airway problems that affect patients with PRS. The findings of this systematic review will help to develop a consensus on the airway and breathing problems in PRS and options for assessment and monitoring of the airway and breathing problem. This data may also contribute to development of a standardized guideline for management of airway and breathing problems in PRS.

Management of upper airway obstruction by non-invasive CPAP in neonates with Pierre Robin sequence

2015 ◽  
Author(s):  
Alessandro Amaddeo ◽  
Veronique Abadie ◽  
Veronique Soupre ◽  
Christel Chalouhi ◽  
Marta Fernandez Bolanos ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Pierre Robin Sequence ◽  
Non Invasive ◽  
Robin Sequence ◽  
Pierre Robin
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