Pierre Robin Sekansı: Yenidoğan Döneminde Hava Yolu Açıklığının ve Beslenmenin Sağlanması

Yıl 2008, Cilt: 8 Sayı: 4, 235 - 242, 01.10.2008

Ayla Günlemez Tonguç İşken

Öz

Pierre Robin Sekansı PRS , mandibula hipoplazisi, glos- sopitozis ve damak yarığı ile karakterize doğumsal bir anomalidir. Çenenin küçük olması dilin hipofarenkse doğru geriye kaçmasına yol açarak, hava yolu tıkanıklığına neden olabilmekte ve yenidoğan döneminde acil tedavi gerektiren önemli sorunlar ortaya çıkabilmektedir. Hava yolu tıkanıklığına yönelik erken ve uygun yaklaşım yapıl- madığında, gereksiz invaziv girişimler uygulanabilmekte ya da hastalar hipokside kalabilmektedir. Bu makalede, kliniğimizde izlenen PRS tanısı almış vakaların özellikleri, klinik izlemleri verilmiş ve güncel literatür bilgileri ışığın- da tedavi yaklaşımları derlenmiş ve tartışılmıştır

Anahtar Kelimeler

Pierre Robin Sekansı, üst hava yolu tıkanıklığı, yenidoğan canlandırması, hava yolu açılması

Pierre Robin Sequence; Airway Management and Feeding in Newborn

Öz

Pierre Robin Sequence PRS is a congenital abnormality characterized by the presence of the mandibular hypoplasia glossoptosis and often a cleft palate. Infants with PRS varying degrees of upper airway obstruction and life threatening complication especially in newborn period secondary to micrognathy and posterior displacement of the tongue base. Diagnosis of PRS should be made immediately and the least invasive intervention should be considered before more invasive approaches, to minimize morbidity such as hypoxia. In this article, we evaluated our experience of airway management of PRS cases and discuss optimal airway and feeding management in PRS infant in light of the foregoing literature.

Anahtar Kelimeler

Pierre Robin Sequence, high upper airway obstruction, neonatal resuscitation, airway management

Kaynakça

• Alan HJ. The respiratory system. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Neonatal Perinatal medicine. 8th ed, Philadelphia: Mosby Elsevier 2006: 1144.
• (Pierre Robin Syndrome). British Journal of Plastic Surgery, ; 36:434-7. gement of the airway in the Pierre Robin syndrome using a modified nasopharyngeal tube and pulse oximetry. Br J Oral Maxillofac Surg 2003; 41:272-4. and implications for nursing practice. J Pediatr Nurs 2001; :23-34. to distract: an algorithm for airway management in isolated
• Pierre Robin sequence. Plast Reconstr Surg 2004; 113:1113
• Atasay B, Günlemez A, Arsan S. Pierre Robin sendromu- üç vaka sunumu, Ankara Üniversitesi Tıp Fakültesi Mecmuası, ; 54:273-6. de. Presented at the American Association of Plastic Surgeons st Annual Meeting, Seattle, 2002: 26-29.
• MC. A modified nasopharyngeal tube to relieve high upper airway obstruction. Pediatr Pulmonol 2000; 29:299-306.
• Smith MC, Senders CW. Prognosis of airway obstruction and feeding difficulty in the Robin sequence. Int J Pediatr Otorhinolaryngol 2006; 70:319-24. gement of airway in Pierre Robin Syndrome. Br J Oral Maxillofac Surg 2004; 42:176. ment of upper airway obstruction in Pierre Robin sequence using a nasopharyngeal airway. Cleft Palate Craniofac J 2007; :269-73.
• Tongue-lip adhesion in the management of Pierre Robin sequ- ence with airway obstruction: technique and outcome. Chang Gung Med J 2005; 28:90-6.
• Management of infants with Pierre Robin sequence. Cleft Palate Craniofac J 2003; 40:180-5. management in Pierre Robin sequence: is there a role for tongue-lip adhesion? Cleft Palate Craniofac J 2003; 40:13-8.
• Evans AK, Rahbar R, Rogers GF, Mulliken JB, Volk MS. Robin sequence: a retrospective review of 115 patients. Int J Pediatr Otorhinolaryngol 2006; 70:973-80. upper airway obstruction. Arch Dis Child 1999; 80:186-7.
• Myer CM, Reed JM. Airway management in Pierre Robin syndrome. Otolaryngol Head Neck Surg 1998; 118:630-5.
• Yao CT, Wang JN, Tai YT, Tsai TY, Wu JM. Successful management of a neonate with Pierre-Robin syndrome and severe upper airway obstruction by long term placement of a laryngeal mask airway. Resuscitation 2004; 61:97-9. two of newborns with Pierre Robin Sequence: the use of dis- posable vs multiple use LMA for fiberoptic intubation. Paediatr Anaesth 2006; 16:1274-6. adhesion for neonatal respiratory distress caused by Pierre
• Robin sequence. J Craniofac Surg 2004; 15:819-23. ence: review of treatment modalities for airway obstruction in cases. Int J Pediatr Otorhinolaryngol 2002; 65:45-51.