title: Airway management in pierre robin sequence: patterns of practice.
abstract: Objectives : To report survey results from American Cleft Palate-Craniofacial Association members on the practice patterns of airway obstruction management in patients with Pierre Robin sequence. Design : A 10-question online survey was sent and the data were reviewed. Setting : Online survey of members of the American Cleft Palate-Craniofacial Association. Patients : Surveys assessed management patterns of patients with Pierre Robin sequence whom a surgeon member of the American Cleft Palate-Craniofacial Association treated for airway obstruction. Interventions : The survey comprised data on management strategies for airway obstruction in Pierre Robin sequence, including tracheostomy, tongue-lip adhesion, mandibular distraction, and treatments that falls in the "other" category. Results : A total of 87 American Cleft Palate-Craniofacial Association members completed the survey. Respondents' results were analyzed as a whole and by individual subspecialty: plastic surgery (n = 33), oromaxillofacial surgery (n = 21), and otolaryngology (n = 29). Although most of the surgeons were trained to manage airway obstruction in Pierre Robin sequence patients using tracheostomy (47%, n = 39) and tongue-lip adhesion (31%, n = 26), 48% reported a current preference for mandibular distraction (n = 40). Of surgeons who preferred to manage Pierre Robin sequence with tongue-lip adhesion (n = 23), 65% were trained to do so (n = 15). Surgeons preferring mandibular distraction (n = 40) and tracheostomy (n = 14) more often reported they were trained to manage Pierre Robin sequence with tracheostomy. Conclusions : Currently there are various practice patterns for the management of airway obstruction in Pierre Robin sequence. Training habits and subspecialty category may influence a surgeon's preference in patients who fail conservative therapy. Treatment guidelines are lacking and may require significant collaboration among centers and subspecialties to develop a more standardized approach to a challenging clinical entity.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Collins
authors.forename: Rosser
authors.initials: R
authors.lastname: Powitzky
authors.forename: Candace
authors.initials: C
authors.lastname: Robledo
authors.forename: Christopher
authors.initials: C
authors.lastname: Rose
authors.forename: Robert
authors.initials: R
authors.lastname: Glade
mesh_terms: D058109:Airway Management / Q000379:methods*; D006801:Humans; D010855:Pierre Robin Syndrome / Q000503:physiopathology* / Q000601:surgery*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States
keywords: Pierre Robin sequence; airway obstruction; micrognathia