revision received

In 1923, a French physician described a set of facial abnormalities that led to ob-struction of the upper airway. These included micrognathia (an undersized jaw) and glossoptosis (an abnormal posterior positioning of the tongue).1 The physician, Pierre Robin, MD, postulated that the abnormally small mandible led to the malpositioning of the tongue such that it occluded the upper airway, making it difficult to breathe. Today, we recognize Pierre Robin sequence (PRS), also known as Pierre Robin syn-drome, as micrognathia, glossoptosis, and obstruction of the airway, often accompanied by palatal abnormalities.1-7 Because the positioning, size, shape, and orientation of the man-dible aids in the positioning of the tongue, the micrognathia seen in PRS leads to a shorter floor of the mouth and is believed to be the cause of the posterior positioning of the tongue and suckling difficulty.2,4-7 With airway obstruction as a key feature of PRS, often a newborn will present in the first few days of life with oxygen desaturation, apnea, and cyanosis.4 Specifically, the airway obstruction hinders inspiration, leading to increased respiratory effort, in which the new-born must use the accessory inspiratory muscles, which can be detected on physical exami-nation.4-7 Simple positional changes may provide some relief. For example, placing the newborn in a prone position may be helpful compared with the supine position, whic