Cleft palate in Pierre Robin sequence

Abstract

Pierre Robin’s sequence PRS is a congenital malformative sequence with a retrognathism, a glossoptosis and an upper respiratory obstruction with an associated cleft palate. This malformative association can be disabling for both the child and his parents, because of its aesthetic, functional, psychological and social impacts. Patients and methods: We have investigated 14 patients with PRS presenting cleft palates, collected over a period of 5 years, from March 2014 to November 2019 in the pediatric surgical emergencies department (PSE) in Rabat Children’s Hospital (HER). Results: Nine of the 14 patients had a complete cleft palate. The average age of intervention was 23 months ranging from 13 months to 4 years. The study showed a slight female predominance (n = 8, 57%). Regarding the treatment, 3 patients were treated with the Bardach’s technique, 3 had the Von Langenbeck’s technique, 3 had the Push-back technique and one patient who suffered from a post-operative persisting velar division was treated by veloplasty 3rd generation. The hospital stay was around 24 hours and the post-operative follow-up was uncomplicated for all our patients. Conclusion: Although we had a relatively high success with our approach, the complexity and lack of consensus regarding the management of Pierre Robin’s sequence still requires the involvement of a multidisciplinary team. The main aim is to give the best aesthetical and functional results in order to reduce the suffering of the PRS children and families.

Keywords

• cleft palate
• retrognathism
• glossoptosis
• dysmorphia
• pierre-robin sequence
• surgery