The role of the nasopharyngeal prong in craniofacial disorders in particular the Pierre Robin sequence

• Published in: Seminars in fetal & neonatal medicine Vol. 26; no. 6; p. 101285
• Main Authors: Abel, Francois, Wallis, Colin
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.12.2021
• Subjects: Airway Obstruction - etiology; Airway Obstruction - surgery; Child; Cleft Palate - complications; Humans; Mandible - surgery; Micrognathia; Nasopharyngeal prong; Pierre Robin management; Pierre Robin Syndrome - complications; Pierre Robin Syndrome - surgery; Robin sequence; Syndrome airway obstruction; Tongue - surgery; Pierre Robin management; Micrognathia; Robin sequence; Nasopharyngeal prong; Syndrome airway obstruction
• ISSN: 1744-165X; 1878-0946
• DOI: 10.1016/j.siny.2021.101285

There are a wide range of surgical and maxillofacial options to alleviate upper airway obstruction in children with craniofacial disorders. The nasopharyngeal prong (NPP) is a simple idea where the airway obstruction arising from the posteriorly placed tongue secondary to a small mandible can be overcome quickly and without resorting to more invasive surgical procedures. The role of the NPP is of particular interest in Robin sequence (RS). RS describes a congenital anomaly with retrognathia (often with associated U-shaped cleft palate) where in some children the tongue and small jaw can significantly impact on airway patency with upper airway obstruction. The NPP is a modified endotracheal tube, of ideal diameter and cut to a desired length that can bypass the airway obstruction and regain patency to the upper airway. RS has a natural history of mandibular growth and resolution of the symptoms with time and thus the NPP presents a medium term solution precluding the need in selected children of more permanent and potentially unnecessary surgical procedures. The role of the NPP in other craniofacial disorders (either as a temporary solution or longer term option) requires further research.