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Craniofacial disorders associated with airway obstruction in the neonate

Christopher M Cielo1, Fernando M Montalva2, Jesse A Taylor3

  • 1Perelman School of Medicine at the University of Pennsylvania, Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Seminars in Fetal & Neonatal Medicine
|March 22, 2016
PubMed

Insights

Infants with craniofacial disorders often experience upper airway obstruction, a serious risk for neonatal mortality. This review focuses on evaluating and managing this condition, particularly in Pierre Robin sequence.

Area of Science:

  • Neonatal Medicine
  • Pediatric Surgery
  • Genetics

Background:

  • Upper airway obstruction (UAO) is a major cause of morbidity and mortality in neonates with craniofacial disorders.
  • Infants with conditions like Pierre Robin sequence have a high risk of obstructive sleep apnea syndrome.
  • Multidisciplinary team care is essential for timely evaluation and optimal management of these complex cases.

Purpose of the Study:

  • To review the current literature on the evaluation and management of UAO in neonates with craniofacial conditions.
  • To specifically address the challenges and approaches for Pierre Robin sequence.
  • To highlight recent advances and remaining questions in the field.

Main Methods:

  • Literature review of studies on neonatal UAO and craniofacial disorders.
  • Focus on diagnostic tools including history, physical examination, genetic testing, imaging, endoscopy, and polysomnography.
  • Analysis of various surgical and non-surgical treatment options.

Main Results:

  • Craniofacial disorders significantly increase the risk of UAO and obstructive sleep apnea in neonates.
  • A comprehensive evaluation involving multiple diagnostic modalities is crucial.
  • Treatment strategies are diverse, ranging from conservative to surgical interventions, tailored to individual patient needs.

Conclusions:

  • Effective management of UAO in neonates with craniofacial disorders requires a multidisciplinary approach.
  • Early and accurate diagnosis is key to preventing severe outcomes.
  • Continued research is needed to further refine assessment and treatment protocols, especially for Pierre Robin sequence.

Keywords:
Apnea–hypopnea indexCraniosynostosisMicrognathiaObstructive sleep apneaPierre Robin sequenceTreacher Collins

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