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Pierre Robin Sequence: a perioperative review
Franklyn Cladis1, Anand Kumar, Lorelei Grunwaldt
1From the Departments of Anesthesiology and Plastic Surgery, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania; and Pediatric Otolaryngology, UH Rainbow Babies and Children's Hospital CWRU School of Medicine, Cleveland, Ohio.
Anesthesia and Analgesia
|July 22, 2014
Summary
Pierre Robin sequence (PRS) involves micrognathia, glossoptosis, and airway obstruction, leading to respiratory distress and feeding issues. Management requires a multidisciplinary team approach for optimal patient outcomes.
Area of Science:
- Medical Sciences
- Pediatric Care
- Surgical Innovation
Background:
- Pierre Robin sequence (PRS) is characterized by a triad of micrognathia, glossoptosis, and airway obstruction.
- These features commonly lead to significant respiratory distress, feeding difficulties, and failure to thrive in neonates and infants.
- Effective management necessitates a comprehensive, multidisciplinary approach involving various medical and surgical specialties.
Purpose of the Study:
- To provide a perioperative review of Pierre Robin sequence (PRS) management.
- To discuss the clinical presentation, diagnostic hallmarks, and treatment controversies associated with PRS.
- To highlight the critical role of anesthesiology within a multidisciplinary team caring for PRS patients.
Main Methods:
- This review synthesizes information from anesthesiology, plastic surgery, otolaryngology, and speech pathology.
- It examines the clinical presentation and diagnostic criteria for PRS.
- Treatment options ranging from conservative measures to surgical interventions are discussed.
Main Results:
- Airway obstruction and respiratory distress are the primary clinical challenges in PRS.
- A range of treatment modalities exist, tailored to obstruction severity, including prone positioning, airway support, and surgical interventions like mandibular distraction osteogenesis.
- Successful management hinges on coordinated care from a diverse team of specialists.
Conclusions:
- Pierre Robin sequence (PRS) presents complex airway and feeding challenges requiring specialized, multidisciplinary care.
- Anesthesiologists play a pivotal role in the perioperative management of these patients.
- Ongoing discussion and research into optimal PRS care strategies are essential.
