Airway obstruction after lingual frenulectomy in two infants with Pierre-Robin Sequence

Dane J Genther; Margaret L Skinner; Patti J Bailey; Randolph B Capone; Patrick J Byrne

doi:10.1016/j.ijporl.2015.06.035

Airway obstruction after lingual frenulectomy in two infants with Pierre-Robin Sequence

Int J Pediatr Otorhinolaryngol. 2015 Sep;79(9):1592-4. doi: 10.1016/j.ijporl.2015.06.035. Epub 2015 Jul 2.

Authors

Dane J Genther¹, Margaret L Skinner², Patti J Bailey³, Randolph B Capone⁴, Patrick J Byrne⁴

Affiliations

¹ Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States. Electronic address: dgenthe2@jhmi.edu.
² Division of Pediatric Otolaryngology, Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
³ Milton J. Dance Head and Neck Center, Greater Baltimore Medical Center, Baltimore, MD, United States.
⁴ Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Greater Baltimore Cleft Lip and Palate Team, Greater Baltimore Medical Center, Baltimore, MD, United States.

PMID: 26187546
DOI: 10.1016/j.ijporl.2015.06.035

Abstract

Pierre-Robin Sequence (PRS) is defined as the triad of micrognathia, glossoptosis, and cleft palate and affects approximately 1/8500 births. Airway obstruction is common in infants with PRS and results from glossoptosis leading to pharyngeal obstruction. Any procedure that increases the severity of glossoptosis, such as lingual frenulectomy, may increase the risk of obstruction or aggravate existing obstruction. This report discusses two cases of significant airway decompensation after lingual frenulectomy requiring surgical intervention in infants with PRS. We suggest that lingual frenulectomy be contraindicated in infants with PRS or suspected PRS due to the possible increased risk of airway obstruction.

Keywords: Airway obstruction; Cleft palate; Lingual frenulectomy; Pediatric otolaryngology; Pierre-Robin Sequence.

Publication types

Case Reports

MeSH terms

Airway Obstruction / etiology*
Humans
Infant, Newborn
Lingual Frenum / surgery*
Male
Pierre Robin Syndrome / surgery*
Postoperative Complications / etiology*