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Updated: Apr 6, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Airway obstruction after lingual frenulectomy in two infants with Pierre-Robin Sequence
Dane J Genther1, Margaret L Skinner2, Patti J Bailey3
1Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Insights
Lingual frenulectomy may worsen airway obstruction in infants with Pierre-Robin Sequence (PRS). This procedure is potentially risky for infants with PRS or suspected PRS, necessitating caution.
Area of Science:
- Pediatric Surgery
- Craniofacial Anomalies
- Neonatal Airway Management
Background:
- Pierre-Robin Sequence (PRS) involves micrognathia, glossoptosis, and cleft palate, affecting 1 in 8500 births.
- Airway obstruction is a frequent complication in PRS due to glossoptosis-induced pharyngeal obstruction.
Abstract:
Pierre-Robin Sequence (PRS) is defined as the triad of micrognathia, glossoptosis, and cleft palate and affects approximately 1/8500 births. Airway obstruction is common in infants with PRS and results from glossoptosis leading to pharyngeal obstruction. Any procedure that increases the severity of glossoptosis, such as lingual frenulectomy, may increase the risk of obstruction or aggravate existing obstruction. This report discusses two cases of significant airway decompensation after lingual frenulectomy requiring surgical intervention in infants with PRS. We suggest that lingual frenulectomy be contraindicated in infants with PRS or suspected PRS due to the possible increased risk of airway obstruction.
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