Pediatric Feeding in Infants With Pierre Robin Sequence Following Mandibular Distraction Osteogenesis Pierre Robin sequence (PRS) causes anomalies that can include micrognathia, cleft palate, and glossoptosis. At birth, infants typically present with a small mandible (micrognathia) which displaces the tongue posteriorly and causes breathing difficulties due to airway obstruction. A large, U-shaped cleft palate is often associated with this condition and the ... Article
Article  |   March 31, 2016
Pediatric Feeding in Infants With Pierre Robin Sequence Following Mandibular Distraction Osteogenesis
Author Affiliations & Notes
  • Kelly Mabry
    Department of Communication Disorders, Southern Connecticut State University, New Haven, CT
    Connecticut Children's Medical Center, Hartford, CT
  • Financial Disclosure: Kelly Mabry is an associate professor at Southern Connecticut State University and a craniofacial speech pathologist at Connecticut Children's Medical Center.
    Financial Disclosure: Kelly Mabry is an associate professor at Southern Connecticut State University and a craniofacial speech pathologist at Connecticut Children's Medical Center.×
  • Nonfinancial Disclosure: Kelly Mabry has no nonfinancial interests related to the content of this article.
    Nonfinancial Disclosure: Kelly Mabry has no nonfinancial interests related to the content of this article.×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Special Populations / Genetic & Congenital Disorders / Part 1
Article   |   March 31, 2016
Pediatric Feeding in Infants With Pierre Robin Sequence Following Mandibular Distraction Osteogenesis
Perspectives of the ASHA Special Interest Groups, March 2016, Vol. 1, 5-9. doi:10.1044/persp1.SIG13.5
History: Received April 24, 2014 , Revised October 26, 2015 , Accepted October 27, 2015
Perspectives of the ASHA Special Interest Groups, March 2016, Vol. 1, 5-9. doi:10.1044/persp1.SIG13.5
History: Received April 24, 2014; Revised October 26, 2015; Accepted October 27, 2015

Pierre Robin sequence (PRS) causes anomalies that can include micrognathia, cleft palate, and glossoptosis. At birth, infants typically present with a small mandible (micrognathia) which displaces the tongue posteriorly and causes breathing difficulties due to airway obstruction. A large, U-shaped cleft palate is often associated with this condition and the combined phenotype can be seen in isolation or in conjunction with a syndrome. In the neonatal period, management of PRS focuses on airway obstruction and feeding through conservative positioning techniques that are often successful. However, infants that do not respond to conservative measures require surgical intervention such as tongue-lip adhesion, tracheostomy, or mandibular distraction osteogenesis (MDO) to manage their airway. While each of these surgical procedures have been used effectively, the process of MDO has become the definitive technique to surgically correct the airway obstruction in PRS by lengthening the mandible, which also brings the tongue forward and out of the airway.

Feeding intervention is directly related to the resolution of micrognathia which in turn advances the tongue base anteriorly, resolving the glossoptosis and airway obstruction. The infant's feeding experience, including pre-surgery and post-surgery considerations, are discussed.

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