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This condition will also cause the baby to have a cleft palate (open roof of mouth). The child will present with a very small or receding chin and the tongue will appear large. The cleft in the palate will have a U-shape, which is more typical of clefts formed due to Pierre Robin sequence.

Causes of Pierre Robin Sequence

Pierre Robin sequence happens during a series of events during the child’s development as an embryo (that is why it is called a sequence). The cause of these events is unknown.

Treatment of Pierre Robin Sequence

The most important goal in treatment of Pierre Robin sequence is making sure the child is able to breathe adequately. This can be achieved by position changes, placement of nasal trumpets (tubes that keep the airway open), tongue-lip adhesion surgery, mandibular distraction or tracheostomy. It will also be important to make sure the child is able to feed without difficulty. Our speech pathologist and feeding specialist will help your child every step of the way during this process.

The cleft palate is usually surgically repaired around 12 months of age. The timing of this surgery will depend on the child’s breathing and your surgeon. Your child may also need ear tubes placed, which will be determined by your child’s ENT surgeon. Your child will be followed by all the members of our dental team over the course of your child’s life.

To learn more about the treatment of Pierre Robin sequence, please call to meet with one of our craniofacial surgeons.

Before & After

This 16-year-old patient of Dr. Wornom was born with Pierre Robin Sequence, which included a cleft palate and a small jaw. He had trouble breathing and eating during infancy and required a tracheostomy and feeding tube as a baby. Dr. Wornom cared for him through this and repaired his cleft palate. At age 2 he underwent distraction osteogenesis of his lower jaw, a procedure which moved the jaw forward, which successfully led to removal of his tracheostomy, and he was able to begin eating and no longer needed a feeding tube. He continued to grow with speech therapy and orthodontic care, and is able to talk normally now, is doing well in school, and enjoys hunting and fishing.

These pictures show him pre and post op after his most recent surgery for his persistent small jaw and chin. Dr. Wornom moved his chin bone forward by cutting the bone and sliding it forward and fixing it there through an incision in his mouth. This procedure also helped his sleep apnea. After a long journey over 16 years it is unlikely he will need any additional surgery.

This patient demonstrates the importance of long-term team care for complex problems which present in infancy. Here at Richmond Plastic Surgeons, Dr. Wornom and Dr. Aboutanos, along with the cleft and craniofacial team at St. Mary’s Hospital provides this care to many children.

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