The combination of micrognathia and cleft palate may be part of Pierre Robin sequence or part of a more complex syndrome. Simple Pierre Robin sequence will improve with growth and any airway obstruction has usually resolved by 9 months. We use a nasopharygeal airway to manage airway obstruction during this 9 month period. Usually the NPA remains in-situ 24/7 for 3 months, and the child is exclusively NG fed. At 3 months we resize the NPA and re-study with overnight polygraphy. There may be an opportunity from 3 months to remove the NPA for short periods during the day, and to potentially start feeding by mouth during these periods. At 6 months we re-study with overnight polygraphy and aim to remove the NPA for the daytime thereafter. At 9 months we re-study with overnight polygraphy with the NPA removed. We re-study on one further occasion after the cleft is repaired.

Cleft Palate South Wales Management Pathway 2026 can be found here.
Guidelines for the management of NPA can be found here.