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Pierre Robin Sequence: evaluation, management, indications for surgery, and pitfalls.

Andrew R Scott¹, Robert J Tibesar, James D Sidman

¹Department of Otolaryngology - Head & Neck Surgery, Floating Hospital for Children - Tufts Medical Center, Tufts University School of Medicine, Box 850, 800 Washington Street, Boston, MA 02111, USA. ascott@tuftsmedicalcenter.org

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|May 17, 2012

Summary

Pierre Robin Sequence (PRS) in infants often causes breathing and feeding issues. Early mandibular distraction osteogenesis shows promise in managing these symptoms, offering significant benefits for affected children.

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Area of Science:

Craniofacial surgery
Pediatric medicine
Neonatology

Background:

Infants with Pierre Robin Sequence (PRS) frequently experience life-threatening airway obstruction and significant feeding difficulties due to retrognathia.
Current management strategies for PRS involve a range of interventions, each with its own efficacy and drawbacks.

Purpose of the Study:

To review current treatment modalities for airway obstruction and feeding challenges in infants with Pierre Robin Sequence.
To specifically evaluate the advantages and disadvantages of early mandibular distraction osteogenesis (MDO) in managing these dual issues.

Main Methods:

Literature review of treatment options for Pierre Robin Sequence.
Analysis of studies focusing on mandibular distraction osteogenesis in infants.
Comparative assessment of MDO against other conservative and surgical interventions.

Main Results:

Mandibular distraction osteogenesis effectively addresses both airway obstruction and feeding difficulties in infants with PRS.
Early intervention with MDO demonstrates considerable benefits in improving respiratory function and nutritional intake.
Limitations of MDO, such as surgical risks and the need for specialized care, are also identified.

Conclusions:

Early mandibular distraction osteogenesis is a valuable therapeutic option for infants with Pierre Robin Sequence.
MDO offers a comprehensive solution for the complex airway and feeding problems associated with PRS.
Further research should focus on long-term outcomes and optimizing MDO protocols.