Management of infants with Robin anomaly.

Congenital micrognathia and secondary glossoptosis, with or without cleft palate, constitute the Robin anomaly. Neonates with this condition are usually at great risk for life-threatening respiratory and feeding problems. The approach to the management of infants with this condition has included, in order of increasing complexity, positioning of the patient, surgical tongue-lip adhesion and tracheostomy. Because of dissatisfaction with the effectiveness of surgical tongue-lip adhesion, and a desire to avoid performing a tracheostomy, a trial of intense non-surgical management was instituted. Ten consecutive patients admitted to the Boston Floating Hospital with Robin anomaly were treated successfully by positioning, without requiring tongue-lip adhesion or tracheostomy. Medical management procedures are outlined and discussed.