Non-operative interventions for Pierre-Robin sequence: A systematic review and meta-analysis

Area of Science:

• Pediatrics
• Otolaryngology
• Respiratory Medicine

Background:

• Pierre-Robin Sequence (PRS) is characterized by micrognathia, glossoptosis, and airway obstruction.
• Management of respiratory distress in PRS infants lacks standardized guidelines, and surgical options carry risks.
• Non-operative interventions offer an alternative for PRS airway management.

Purpose of the Study:

• To systematically review all non-operative airway intervention modalities for infants with Pierre-Robin Sequence.
• To identify the most frequently used non-operative treatments for PRS-related respiratory distress.

Main Methods:

• Systematic review following PRISMA 2020 guidelines.
• Searched Embase, Medline, Cochrane, EMCARE, and Web of Science databases (1992-2022).
• Included studies focused on non-operative management of PRS infants under one year; excluded non-original research, surgical-only focus, case reports, and non-English articles.

Main Results:

• 88 articles were included from 3280 screened abstracts.
• Non-operative interventions were used in 65.8% of 4708 PRS infants across 60 studies.
• Common non-operative interventions included infant positioning (1664), orthodontic appliances (1299), and nasopharyngeal tubes (983).

Conclusions:

• Non-operative management is the predominant approach for PRS infants.
• Infant positioning, orthodontic appliances, and nasopharyngeal tubes are the most frequently reported non-operative interventions.
• Further research may be needed to address the moderate methodological quality of included studies.