Three Cases of Pierre Robin Sequence with Upper Airway Obstruction Relieved by Nasopharyngeal Airway Insertion

Abstract

Pierre Robin sequence (PRS), also called Robin sequence, is a congenital anomaly characterized by a triad of micrognathia, glossoptosis, and upper airway obstruction. Infants with PRS can present with varying degrees of respiratory difficulty secondary to upper airway obstruction. There has been no consensus for the treatment of upper airway obstruction in infants with PRS, but recent studies recommend attempting non-surgical interventions before surgical treatment. In this case report, we present 3 cases of infants diagnosed with PRS who showed persistent respiratory difficulties after birth. Before considering surgical intervention, insertion of a nasopharyngeal airway was attempted in these infants. Following this procedure, symptoms of upper airway obstruction were relieved, and all infants were discharged without surgical interventions; the nasopharyngeal airway was removed 1 to 2 months later. To date, no infant has shown signs of upper airway obstruction. Nasopharyngeal airway insertion is a highly effective and less invasive treatment option for infants with PRS. However, it is not widely known and used in Korea. Nasopharyngeal airway insertion can be preferentially considered before surgical intervention for upper airway obstruction in such infants.

Manejo multidisciplinario de las alteraciones maxilofaciales asociadas al Síndrome de Pierre Robin. Revisión de literatura

“…En el caso que la posición prona fracase, está indicado la colocación de una sonda nasofaríngea que consiste en un tubo flexible insertado en la fosa nasal con el extremo distal ubicado en la laringe, justo encima de la epiglotis. Este procedimiento es altamente efectivo y menos riesgoso pues permite que la lengua se mueva hacia adelante y el recién nacido respire a través de él 27 . Otra alternativa no quirúrgica es la placa palatina modificada.…”