scholarly journals Airway and feeding problems in infants with Fairbairn-Robin triad deformities

Curationis ◽  
2013 ◽  
Vol 36 (1) ◽  
Author(s):  
Susanna M. Du Plessis ◽  
Hester J.S. Van den Berg ◽  
Kurt W. Bütow ◽  
Christiaan F. Hoogendijk
Keyword(s):  
Airway Obstruction ◽  
Growth And Development ◽  
Upper Airway ◽  
Descriptive Statistics ◽  
Nutritional Management ◽  
Pierre Robin Sequence ◽  
Feeding Problems ◽  
Surgical Interventions ◽  
Feeding Difficulties ◽  
Pierre Robin

Background: The majority of patients with Pierre Robin sequence in the subdivision Fairbairn-Robin triad (FRT), are born with glossoptosis, retro-/micrognathia and cleft or agenesis of the palate leading to feeding difficulties and airway obstruction. There is limited literature on these problems, and on methods used to address them.Objectives: Community nurses in the Facial Cleft Deformity Clinic evaluate associated airway obstruction and feeding problems and devise nursing interactions to address these. This retrospective study examined the incidence of airway and feeding difficulties in the neonatal, pre-surgical period, as well as the surgical and nutritional management of these infants.Method: Retrospective records of 215 infants with FRT were examined and data on incidence, airway and feeding difficulties and surgical and nutritional management was collected. Descriptive statistics, including average and percentage values, were compiled.Results: The incidence of FRT amongst the cleft palate patients was 6.0%, with 37.7% of these having feeding difficulties. However, surgical interventions such as glossopexy (5.6%), distraction osteogenesis (0.9%) and tracheotomy (2.3%) for airway management were seldom required. Most of the infants who had upper airway obstruction and feeding problems were handled by means of suction and drinking plates, along with additional specific feeding aids. This reduced airway obstruction in 70.6%, and feeding problems in 62.4% of these infants.Conclusion: Based on this study’s finding the introduction of the suction and drinking plate and the use of specific types of feeding devices and surgical management can improve growth and development in infants with FRT.

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.

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

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.

scholarly journals Surgical Versus Nonsurgical Interventions to Relieve upper Airway Obstruction in Children with Pierre Robin Sequence

2015 ◽  
Vol 22 (3) ◽  
pp. 171-175 ◽  
Author(s):  
Karen Kam ◽  
Meghan McKay ◽  
Joanna MacLean ◽  
Manisha B Witmans ◽  
Sheldon Spier ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Airway Obstruction ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Pierre Robin Sequence ◽  
Pierre Robin

BACKGROUND: Newborns with Pierre Robin sequence (PRS) often experience chronic intermittent hypoxemia/hypoventilation associated with airway obstruction. The heterogeneity of the severity of upper airway obstruction makes management a challenge; the optimal intervention in individual cases is not clear.OBJECTIVE: To investigate the prevalence of surgical/nonsurgical interventions for PRS at two children’s hospitals. Patient characteristics and outcomes were examined.METHODS: The present retrospective chart review identified 139 patients with PRS born between 2000 and 2010. Demographic information, mode of airway management, associated anomalies and syndromes, polysomnography results, length of intensive care unit and hospital stay, complications and deaths were extracted.RESULTS: Interventions included prone positioning (alone [61%]), tongue-lip adhesion (45%), nasopharyngeal intubation (28%), continuous positive airway pressure (20%), tracheostomy (19%) and mandibular distraction osteogenesis (5%). Tracheostomies were more prevalent in syndromic patients (P=0.03). Patients who underwent tracheostomy had a lower birth weight (P=0.03) compared with newborns with other interventions. Patients who underwent surgical interventions had longer intensive care unit stays (P<0.001). No intervention was associated with a statistically significant likelihood of requiring a subsequent intervention. Thirty percent of patients underwent polysomnography, with a higher proportion of these using continuous positive airway pressure (n=15) (P<0.01).CONCLUSIONS: In the present descriptive study, patients with syndromic PRS or low birth weight underwent early intervention, which included a tracheostomy. Objective measures of airway obstruction were underutilized. Decision making regarding evaluation and management of upper airway obstruction in this population remains clinician and resource dependent. Reporting data obtained from a large cohort of PRS patients is important to compare experiences and motivate future studies investigating this complex condition.

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