A newborn has micrognathia, cleft palate, and glossoptosis causing airway obstruction. The tongue is posteriorly displaced. What is the most appropriate initial management?

• A Prone positioning ✓
• B Immediate tracheostomy
• C Nasopharyngeal airway insertion
• D Tongue-lip adhesion surgery

Explanation

This describes Pierre Robin sequence. The airway obstruction is caused by micrognathia leading to posterior displacement of the tongue (glossoptosis). Prone positioning is the first-line management as gravity pulls the tongue forward, relieving the obstruction in most cases. Tracheostomy is reserved for severe refractory cases. Nasopharyngeal airway may be used if prone positioning fails. Tongue-lip adhesion is a surgical option for persistent cases.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.