In Pierre-Robin syndrome management, which airway strategy is helpful?

• A. Place neonate supine
• B. Use towel rolls under shoulders and forehead
• C. Tracheostomy
• D. Surgical correction

Answer: (B)

In Pierre-Robin sequence the airway is mainly compromised by the tongue falling back (glossoptosis) because of the small jaw. The simplest, most effective initial approach is noninvasive positioning that aligns the airway and prevents the tongue from occluding the passages. Placing towels under the shoulders and forehead creates a gentle neck extension and chin-forward position. This helps move the mandible slightly forward and pulls the tongue away from the back of the throat, opening the oropharyngeal airway and improving airflow without invasive intervention. It’s a practical, immediate measure that can make a real difference in breathing and feeding for a newborn with mild to moderate obstruction.

Supine positioning tends to worsen glossoptosis and airway collapse. A tracheostomy is a drastic, invasive step reserved for severe, unrelieved obstruction. Surgical correction isn’t an acute airway management strategy and isn’t used to rapidly relieve airway obstruction in newborns.