[Neonatal treatment of stage 3 Pierre Robin sequence by mean of a naso-pharyngeal tube]

Abstract

Introduction: In the stage 3 Pierre Robin sequence, glossoptosis is responsible for pharyngeal obstruction and for respiratory and eating disorders. An alternative to labioglossopexie, tracheotomy or mandibular distraction is the placing of a nasal pharyngeal tube in order to lift the lingual obstacle.

Material and method: In our series of 15 new born with a stage 3 Pierre-Robin sequence, the nasal pharyngeal tube was positioned a few days after birth.

Result: Ventilation and oxygen saturation were satisfactory. A lowering of hypercapnia and a rise of the weight curve were observed. The tube had to be maintained 64 days on average. No specific complication was noticed.

Discussion: The nasal pharyngeal tube lifts the lingual obstacle, improves hypercapnia and allows for a weight gain. In case of glossoptosis, hypercapnia may be ignored or underestimated. Normal oxygen saturation may be falsely reassuring while severe hypercapnia is occurring. Attentive care and parental involvement are needed.

Keywords: Hypercapnia; Hypercapnie; Nasopharyngeal; Nasopharynx; Nursing; Pierre Robin’ sequence; Soins; Séquence de Pierre-Robin.