Pierre Robin Sequence (Differential Diagnosis RDS)

atno_19a_n.jpg: 1-day-old newborn with signs of a respiratory distress syndrome (costal margin retractions, stress). The region of the chin is depressed = retro- and hypognathia of the lower jaw. atno_19b_n.jpg: The inspection of the mouth shows mostly a cleft palate with a rounded end; the tongue is displaced toward the back = ptosis of the tongue. The displaced base of the tongue touches the posterior pharyngeal wall, and the residual tongue may lie within the nasal cavity. The diagnosis is the relatively frequent Pierre Robin sequence with a connection to the cleft palate. The displacement of the tongue behind the mouth and the abnormal pattern of contractions of pharyngeal muscles cause a respiratory distress syndrome or an obstruction of the airways of varying degree and secondary feeding problems. Additional pharyngeal dismotility and a frequent gastroesophageal reflux may increase the shortness of breath due to aspirations; $$atno_22bis??££see picture for comparison§§. Figure atno_19c_n.jpg: In prone position and - if needed - supported by a suspensory system of the head, the tongue falls forward and the airways open. Prompt oral feeding actively stimulates a normal position of the tongue and a corrective growth of the lower jaw.