Treatment of PRS is multifaceted and individualized, with surgery being performed only to solve the functional problems that a patient may have. Surgical treatments may be indicated for PRS patients with more severe clinical conditions, often those associated with airway impairment.
Infants with PRS should be observed closely for breathing difficulties. Placing the child on his or her stomach (prone position), rather than on his or her back, can help prevent the tongue from falling back toward the throat. If this does not solve the problem of airway obstruction, small tube-like instruments such as a ‘nasopharyngeal airway’ may be inserted into the nose to keep the airways open. If airway obstruction is even more severe, a tube may be inserted in the infant’s throat in hospital (intubation) or, rarely, a surgical opening may be made into the trachea through the neck (tracheostomy) to assist the infant in breathing.
To close the cleft palate, surgery is typically performed between 12 and 18 months of age. Doctors may postpone the corrective surgery, however, to allow the opening in the palate to close on its own as natural growth occurs.
Surgery to improve the appearance of the jaw is rarely necessary because the small lower jaw seen at birth most often grows to a more normal size by 18 months of age. To address feeding-related difficulties, a variety of specially adapted bottles and nipples may be used. If feeding problems are unresolved and severe, a feeding tube may be needed temporarily in order to assist with proper weight gain.
Symptomatic and supportive treatment may be provided using a multidisciplinary team approach, in order to best meet the needs of the affected individual. If speech is impaired, the child should participate in speech therapy or be monitored by a speech pathologist. Ear, nose, and throat doctors (otolaryngologists) and audiologists can provide follow-up on ear- and hearing-related issues. Surgically placed drainage tubes may be recommended if ear infections are recurrent. A combination of orthodontists, maxillofacial surgeons, and dentists may work together to monitor the oral cavity, for example by looking to avoid crowding of the teeth and to ensure proper tooth alignment. Ophthalmology may be consulted to monitor for ocular abnormalities. Genetic counseling may be of benefit for patients and their families.