Resolving Feeding Difficulties With Early Airway Intervention in Pierre Robin Sequence
Article first published online: 2 JAN 2009
Copyright © 2008 The Triological Society
Volume 118, Issue 1, pages 120–123, January 2008
How to Cite
Lidsky, M. E., Lander, T. A. and Sidman, J. D. (2008), Resolving Feeding Difficulties With Early Airway Intervention in Pierre Robin Sequence. The Laryngoscope, 118: 120–123. doi: 10.1097/MLG.0b013e31815667f3
- Issue published online: 2 JAN 2009
- Article first published online: 2 JAN 2009
- Manuscript Accepted: 24 JUL 2007
- Pierre Robin;
- pediatric airway;
- pediatric feeding;
- cleft palate
Objectives/Hypothesis: To observe rates of gastrostomy tube (g-tube) placement in Pierre Robin Sequence (PRS) and to determine whether relieving airway obstruction solves feeding difficulties.
Study Design: All PRS referrals to a multidisciplinary cleft team for children at a tertiary pediatric hospital from January 1988 to June 2006 were retrospectively reviewed.
Methods: Patients were analyzed for occurrence of g-tube placement, neurologic disorders, and airway intervention including tracheotomy and mandibular distraction osteogenesis.
Results: Sixty-seven PRS patients were divided into two categories: 51 (76.1%) isolated PRS (iPRS) and 16 (23.9%) with additional disorders and syndromes (sPRS). Patients were then placed into two subgroups: those who received early airway intervention and those who received late or no airway intervention. Of the 51 iPRS children, 12 (23.5%) received early airway intervention, none of whom required a g-tube. There were 39 (76.5%) children who received late or no airway intervention, and 5 (12.8%) of these required g-tube placement. Of the 16 sPRS children, 8 (50%) received early airway intervention, and 7 (87.5%) of these still required a g-tube. Of the remaining 8 (50%) sPRS patients who received late or no airway intervention, 5 (62.5%) required a g-tube.
Conclusion: In children with iPRS, feeding difficulties can be resolved with early airway intervention. Delaying airway intervention may necessitate feeding assistance because all of the iPRS children who required a g-tube fell into this category. The presence of additional disorders and syndromes further complicates treatment because most of the sPRS children required g-tubes regardless of airway intervention.