Associated syndromes in patients with Pierre Robin Sequence

Int J Pediatr Otorhinolaryngol. 2020 Apr:131:109842. doi: 10.1016/j.ijporl.2019.109842. Epub 2019 Dec 30.

Abstract

Objectives: Classically, Pierre Robin Sequence (PRS) is a triad of micrognathia, glossoptosis, and airway obstruction, although frequently associated with cleft palate. Current literature reports that Stickler syndrome is the most common syndrome associated with PRS, and 22q11 deletion syndrome (22q11 DS) as the second most common. This study identifies associations between PRS and genetic syndromes.

Methods: A retrospective chart review was performed to identify patients diagnosed with PRS over a 10-year period from 4/1/2007 to 4/1/2017 at a tertiary children's hospital.

Results: 4,052 consecutive charts were reviewed and 234 patients had a diagnosis of PRS confirmed with the triad of micrognathia, glossoptosis, and airway obstruction. Of note, all of these patients had cleft palate. Of the 234 patients with PRS, 65 patients had syndromic diagnoses (28%). One patient had 22q11 DS (0.43%), and 31 patients had Stickler syndrome (13.2%). Additionally, 3 patients had central hypoventilation syndrome, 3 patients had Duane syndrome, 2 patients had Cornelia de Lange syndrome, 2 patients had Emanuel syndrome, 2 patients had Gordon syndrome, 2 patients had Mobius syndrome, 2 patients had Nager syndrome. Multiple other syndromes were identified, but occurred in isolated cases.

Conclusion: This study supports literature that PRS is most commonly associated with Stickler Syndrome but rarely associated with 22q11 DS given that only 1 patient had both PRS and 22q11 DS.

Keywords: Genetics; Palatal development; Pierre robin sequence; Velocardiofacial syndrome.

MeSH terms

  • 22q11 Deletion Syndrome / complications
  • Adolescent
  • Arthritis / complications*
  • Arthrogryposis / complications
  • Child
  • Child, Preschool
  • Chromosome Disorders / complications
  • Cleft Palate / complications
  • Clubfoot / complications
  • Connective Tissue Diseases / complications*
  • De Lange Syndrome / complications
  • Duane Retraction Syndrome / complications
  • Female
  • Hand Deformities, Congenital / complications
  • Hearing Loss, Sensorineural / complications*
  • Heart Defects, Congenital / complications
  • Humans
  • Hypoventilation / complications
  • Hypoventilation / congenital
  • Infant
  • Infant, Newborn
  • Intellectual Disability / complications
  • Male
  • Mandibulofacial Dysostosis / complications
  • Mobius Syndrome / complications
  • Muscle Hypotonia / complications
  • Pierre Robin Syndrome / complications*
  • Retinal Detachment / complications*
  • Retrospective Studies
  • Sleep Apnea, Central / complications

Supplementary concepts

  • Acrofacial dysostosis, Nager type
  • Congenital central hypoventilation syndrome
  • Emanuel syndrome
  • Gordon syndrome
  • Stickler syndrome, type 1