The Jaw Index: New Guide Defining Micrognathia in Newborns

1997 ◽  
Vol 34 (3) ◽  
pp. 240-241 ◽  
Author(s):  
Ibo Van Der Haven ◽  
J. Wiebe Mulder ◽  
Karel G.H. Van Der Wal ◽  
J. Joris Hage ◽  
Elly S.M. De Lange-De Klerk ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Airway Obstruction ◽  
Reference Group ◽  
Relevant Literature ◽  
Pierre Robin Sequence ◽  
Feeding Difficulties ◽  
Robin Sequence ◽  
Life Threatening ◽  
Characteristic Features ◽  
Pierre Robin

Objective Newborns with glossoptosis due to micrognathia can suffer from life-threatening respiratory distress and severe feeding difficulties. These characteristic features are found in newborns with Pierre Robin sequence. In the relevant literature, no concensus concerning diagnosis for these childern can be found. A guide defining micrognathia can be helpful in the diagnosis of glossoptosis and possible airway obstruction. Method The jaw index is obtained in newborns by measuring three facial dimensions. In a series of 100 healthy neonates the standard measures were defined. Results The average jaw index in children with Pierre Robin sequence differs significantly from the reference group and was found to be over 3.6 times the normal value. Conclusions Micrognathia can be defined with the Jaw index.

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.

Using a Modified Nutrition Plate for Early Intervention in a Newborn Infant with Pierre Robin Sequence: A Case Report

2006 ◽  
Vol 43 (3) ◽  
pp. 370-373 ◽  
Author(s):  
Hüsamettin Oktay ◽  
Bülent Baydaş ◽  
Mustafa Ersöz
Keyword(s):  
Case Report ◽  
Early Intervention ◽  
Airway Obstruction ◽  
Upper Airway ◽  
Pierre Robin Sequence ◽  
Prone Positioning ◽  
Feeding Problems ◽  
Robin Sequence ◽  
Life Threatening ◽  
Pierre Robin

Pierre Robin sequence is a triad of micrognathia, glossoptosis, and cleft palate that results in upper airway obstruction and feeding problems. It is a serious condition with potentially severe, life-threatening airway obstruction. Approaches for treatment of airway obstruction among neonates with Pierre Robin sequence include prone positioning of the infant, tongue-lip adhesion, mandibular distraction, and tracheostomy. This case report describes a modified nutrition plate and a baby treated using this appliance.

Cleft Palate, Cleft Lip, and Pierre Robin Sequence

2018 ◽  
Author(s):  
Michelle Keese Harvey ◽  
Ihab Ayad
Keyword(s):  
Cleft Palate ◽  
Airway Obstruction ◽  
Cleft Lip ◽  
Anesthetic Management ◽  
Treatment Options ◽  
Pierre Robin Sequence ◽  
Respiratory Compromise ◽  
Feeding Difficulties ◽  
Robin Sequence ◽  
Pierre Robin

Pierre Robin sequence (PRS) is characterized by micrognathia, glossoptosis, and airway obstruction. Often associated with cleft palate, PRS is usually an isolated finding but is associated with a syndrome one-third of the time. The micrognathia and glossoptosis lead to airway obstruction, respiratory compromise, and feeding difficulties. Severe cases and prolonged and repeated airway obstruction and respiratory distress can lead to failure to thrive, hypoxemia, pulmonary hypertension, cardiac arrest, and death. Treatment options for the management of airway obstruction in PRS depends on the degree of obstruction and any associated comorbidities and range from noninvasive respiratory support to surgical correction of the physical defect. Patients with PRS should be considered as challenging to ventilate and intubate, and the practitioner should be well prepared for the possibility of difficulty with airway management. Anesthetic management is tailored to minimize postoperative upper airway obstruction and avoid disruption of the integrity of the surgical repair.

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.

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