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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.

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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.