Examination of Respiratory Management for Pierre Robin Sequence

• Published in: Journal of Japanese Cleft Palate Association Vol. 33; no. 3; pp. 280 - 289
• Main Authors: HORIKIRI, Masaru, PARK, Susam, MATSUI, Takahiro
• Format: Journal Article
• Language: Japanese
• Published: Japanese Cleft Palate Association 30.10.2008
• Subjects: airway; Pierre Robin sequence; respiratory management; statistical examination; エアウェイ; 呼吸管理法; 統計学的検討
• ISSN: 0386-5185; 2186-5701
• DOI: 10.11224/cleftpalate1976.33.3_280

Pierre Robin Sequence (PRS) is a relatively rare complex of symptoms with three characteristics: glossoptosis, micrognathia, and respiratory obstruction. In severe cases, respiratory management may be required following birth. Since micrognathia does not have a clear definition, diagnostic criteria and the best respiratory care method have not been determined. Herein, we report the results of respiratory management for infants with PRS treated at the Division of Plastic Surgery, Shizuoka Children's Hospital, based on our statistical examination. Thirty-six infants with PRS were retrospectively studied (age of first examination by a plastic surgeon, reason for referral, family history, complications, age of hospitalization, and days of hospitalization). All subjects had a merged cleft palate and 9 (25%) had other complications in addition to a cleft palate, which was in accordance with other reports. Sixteen patients (44.4%) required hospitalization and 5 received endotracheal intubation or surgical management (3 with endotracheal intubation,1 with glossopexy,1 with a frenotomy), though none of the subjects treated in the most recent 10-year period underwent surgery. There was no significant difference in number of days of hospitalization between subjects who received surgical management and those with conservative treatment (e. g., airway). Age of hospitalization and days of hospitalization were not significantly different between nonsyndromic PRS and syndromic PRS patients. Based on our results, we consider that conservative respiratory management for infants with PRS should be the first choice of treatment, because the incidence of syndromic PRS children requiring surgical management was not high and most cases experienced symptom improvement with conservative treatment.