Respiratory distress in Pierre Robin: successful use of pharyngeal tube.
OBJECTIVE
The study describes a safe and least aggressive method to resolve airway obstruction in children born with a Pierre Robin sequence (PRS).


METHODS
In a retrospective study, we analyzed the assessment of airway obstruction at birth and for the following months. The definition of PRS was based on the anatomical anomaly triad cleft palate, micro/retrognathia, and glossoptosis with some degree of airway obstruction. We defined 3 categories of children depending on their difficulties of breathing or eating at birth.


RESULTS
From 1984 to 2004, 48 children were born in our hospital with a diagnosis of PRS. There were 32 children with nonsyndromic PRS (nsPRS) and 16 with syndromic PRS (sPRS): respectively, 40% (13) and 32% (5) had slight respiratory and/or feeding problems; 26% (8) and 56% (9), isolated feeding difficulties; 34% (11) and 12% (2), severe respiratory and feeding problems. Pharyngeal tube was used in 8 children with nsPRS and in 2 with sPRS. Neonatal surgery was not necessary. Primary palatoplasty was performed at almost the same time as for the patients with isolated cleft palate.


CONCLUSIONS
Children born with PRS have a good prognosis at birth provided that adequate respiratory support is given using either positive airway pressure mask or pharyngeal tube.
de Buys Roessingh
Anthony S
AS
Department of Pediatric Surgery, University Hospital Centre of the Canton of Vaud (CHUV), Lausanne, Switzerland. anthony.debuys-roessingh@Chuv.ch
Herzog
Georges
G
Hohlfeld
Judith
J
D000402:Airway Obstruction / Q000209:etiology / Q000628:therapy; D002648:Child; D045422:Continuous Positive Airway Pressure; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D007440:Intubation; D008297:Male; D010614:Pharynx; D010855:Pierre Robin Syndrome / Q000150:complications*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*