Clinical Pathway for Evaluation/Treatment of the Neonate/Infant with Micrognathia/Retrognathia and Concern for Airway Obstruction
Related Pathways
EPIC Order Sets
- Neonate/Infant with Micrognathia or Retrognathia Admission
- Neonate/Infant with Micrognathia or Retrognathia Post Op
N/IICU Admission
- Assess patient prone on room air and observe breathing and vital signs
- History and Physical
- Plastic consult and other subspecialties
- Imaging recommended by Plastic Surgery
- 2 View Skull X-ray
- Facial 3D CT Scan
No airway Support
Non-invasive Airway Support
Obstructive Sleep Apnea
None/Mild/Borderline
None/Mild/Borderline
Obstructive Sleep Apnea
Moderate or Severe
Moderate or Severe
Review with Plastic Surgery & Pulmonary
Continued assessment
Sleep study as clinically indicated
Sleep study as clinically indicated
Intubated Airway
- Mild/moderate micrognathia
- No severe genetic syndromes
- Anatomy based on exam, X-ray
- Discuss continued respiratory support with Pulmonology
- Discuss titration PSG with Pulmonology if on CPAP
(X-ray, distractor site care, skin care, antibiotics, repeat PSG)
Posted: February 2017
Revised: June 2021
Authors: J. Lioy, MD; M. Padula, MD; L. Heimall, MSN; C. Cielo, MD; J. Taylor, MD; S. Bartlett, MD; J. M. Carroll, MSN; J. Swanson, MD
Revised: June 2021
Authors: J. Lioy, MD; M. Padula, MD; L. Heimall, MSN; C. Cielo, MD; J. Taylor, MD; S. Bartlett, MD; J. M. Carroll, MSN; J. Swanson, MD
Evidence
- Neonates with Tongue-based Airway Obstruction: a Systematic Review
- Glossoptosis-apnea Syndrome in Infancy
- The Spectrum of Sleep-disordered Breathing Symptoms and Respiratory Events in Infants with Cleft Lap and/or Palate
- Prevalence and Severity of Obstructive Sleep Apnea and Snoring in Infants with Pierre Robin Sequence
- The Surgical Correction of Pierre Robin Sequence: Mandibular Distraction Osteogenesis Versus Tongue-lip Adhesion
- Disorders of the neonatal airway - Fundamentals for Practice
- Evolution of Obstructive Sleep Apnea in Infants with Cleft Palate and Micrognathia
- Craniofacial Disorders Associated with Airway Obstruction in the Neonate
Community Resources
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