Treatment of Cleft Palate Associated with Robin Sequence: Appraisal of Risk Factors

Abstract

Mandibular hypoplasia, airway obstruction, and a typical wide U-shaped cleft palate comprise the Robin sequence. Although much has been written regarding the treatment of these patients in the neonatal period, the literature reveals little information regarding later care of the cleft palate in these patients. The purpose of this study is to examine patients with the Robin sequence and evaluate the risk of postsurgical problems and outcome related to the neonatal period. Thirty-six patients with the Robin sequence presenting from 1972 through 1990 were reviewed. A majority of patients had feeding and respiratory difficulties, to varying degrees, following birth. These problems were treated successfully by maneuvers ranging from positioning to two infants who eventually required tracheostomy. Thirty-four patients had palate repair. Age at repair averaged 16.2 months, and one third of patients had associated anomalies. Infants who experienced problems following palatoplasty were those who had histories of severe difficulties and complications in the early months of life. In addition, patients with associated congenital anomalies has significantly more problems at the time of palate repair than those without anomalies. Those patients with the Robin sequence, who historically had minimal difficulty following birth, experienced few complications at the time of palate repair. Of the 34 patients with repaired palates, 23 demonstrated sufficient follow-up to allow for evaluation of speech outcome. Satisfactory or normal speech production was noted in 65.4%. This is not significantly different from that observed in all patients undergoing cleft palate repair during this same time period (74.9%). Secondary pharyngoplasty procedures were required in 17.4%.(ABSTRACT TRUNCATED AT 250 WORDS)

Craniofacial Morphology in Young Adults with the Pierre Robin Sequence and Isolated Cleft Palate

“…On the other hand, craniofacial morphology within the PRS group in this study did not vary signScantly with regard to cleft extent. Associated anomalies were also commoner in the PRS group (20°/0) than in the ICP group (12%) but were not deviant, as reported in other studies (24)(25)(26). The difference in the: distribution of operation methods between the Veau--Warddl-Kilner (VK) and Cronin (C) modlfication in the PRS and ICP group may also have had some effect on the results.…”

Do patients with isolated Pierre Robin Sequence have worse outcomes after cleft palate repair: A systematic review

“…Three studies 9,13,14 examined hyponasality of both groups; all found no difference between groups. Three studies 9,11,12 examined the nasal emission of both groups; one study 9 showed increased nasal emission in PRS group. The results of study 5 13 were the final results after velopharyngeal insufficiency (VPI) treatment, which was different from other studies.…”

Acute airway obstruction in an infant with Pierre Robin syndrome after palatoplasty

“…Patients with Pierre Robin sequence and other identified syndromes have been reported to have an increased risk of developing airway obstruction, respiratory distress, severe feeding difficulties, and even death after palatoplasty (2,3,5). Airway morbidity after Wardill-Kilner or von Langenbeck and recently Furlow repair, but not Perko-revised palatoplasty, has been described (6)(7)(8).…”