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Infant hard and soft palates
Infant hard and soft palates

Pierre Robin syndrome
Definition:
A group of abnormalities marked primarily by a very small lower jaw with a tongue that falls back and downward. The syndrome may include a high arched palate or cleft palate.

Alternative Names:
Robin sequence

Causes, incidence, and risk factors:
The specific causes of Pierre Robin syndrome are unknown; it can be part of many genetic syndromes. The lower jaw develops slowly over the first few months of fetal life but catches up over the first year after birth. Posterior placement of the tongue may cause choking episodes, feeding difficulty and breathing difficulties, especially while asleep.
Symptoms:
  • very small jaw with marked receding chin
  • tongue appears large (is actually normal size but big relative to jaw) and is placed unusually far back in the oropharynx
  • high arched palate
  • cleft soft palate
  • choking on tongue
  • natal teeth
Signs and tests:
Physical examination is usually sufficient for your health care provider to diagnose this condition.
Treatment:

Infants must be kept prone (face down), which allows gravity to pull the tongue forward and keep the airway open. These problems abate over the first few years as the lower jaw grows and assumes a more normal size. In moderate cases, the patient requires placement of a nasopharyngeal airway (a tube placed through the nose and into the airway) to avoid airway blockage. In severe cases, surgery is indicated for recurrent upper airway obstruction. Tracheostomy is sometimes required.

Feeding must be done very carefully to avoid choking and aspiration of liquids into the airways.
Expectations (prognosis):
Choking and feeding problems may go away spontaneously as the jaw grows. There is a significant risk of problems if the airway is not protected against obstruction.
Complications:
Calling your health care provider:
This condition is often apparent at birth. Call if choking episodes or breathing problems increase in frequency. Airway blockage may be indicated by a high-pitched, crowing noise when inhaling (stridor) or blueness of the skin (cyanosis). Also call if other breathing problems occur.
Prevention:
Prevention of the syndrome is unknown. Treatment may reduce the number of episodes of breathing problems and choking.
Review Date: 12/3/2001
Reviewed By: David G. Brooks, M.D., Ph.D., Division of Medical Genetics, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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