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BackTable / ENT / Article
Micrognathia (Small Jaw) in Newborns: Evaluation & Management
Megan Saltsgaver • Updated Aug 30, 2024 • 210 hits
Micrognathia, also called “small jaw,” is a condition in which the mandible (lower jaw) is underdeveloped or smaller than it should be. Micrognathia is an important feature to notice in infants where other comorbidities or syndromes may lead to airway obstruction. Pediatric otolaryngologist Dr. Brianna Roby discusses her method for evaluating and managing micrognathia in newborns.
This article features excerpts from the BackTable ENT Podcast. We’ve provided the highlight reel in this article, and you can listen to the full podcast below.
The BackTable ENT Brief
• Micrognathia is used to describe a small jaw while retrognathia is used to describe a jaw that is set back. These terms often get interchanged and it is important to know the difference when communicating with other healthcare professionals.
• Robin Sequence is one of the more common sequences in which you can see micrognathia. It is accompanied by the tongue falling back into the throat (glossoptosis) and causing airway obstruction.
• It can often be difficult to tell if a large tongue is causing the obstructive symptoms or if it's truly glossoptosis, especially when questioning if an infant's jaw is micrognathic or retrognathic. A jaw thrust can be used to distinguish between the two.
• Sleep studies in children with micrognathia shouldn’t always be used to assess obstructive symptoms while sleeping. Instead, CO2 levels should be used to help guide treatment.
Table of Contents
(1) Initial Evaluation of the Infant with a Small Jaw: Distinguishing Micrognathia from Retrognathia
(2) Micrognathia Evaluation in the NICU
(3) How to Determine if a Small Jaw or a Large Tongue is Causing Airway Obstruction
(4) Sleep Disordered Breathing in Micrognathia
Initial Evaluation of the Infant with a Small Jaw: Distinguishing Micrognathia from Retrognathia
Micrognathia and retrognathia are terms that both relate to the mandible, yet they are often confused. Micrognathia refers to a mandible that is smaller than it should be, particularly in comparison to the maxilla. On the other hand, retrognathia describes a jaw that is set back further than normal but is otherwise of typical size.
When performing a physical examination to distinguish between these conditions, the process begins with palpating the angle and body of the mandible. In retrognathic infants, the body of the mandible will feel appropriately sized, whereas in cases of micrognathia, the angle can be felt, but the body is notably underdeveloped.
Robin Sequence, previously known as Pierre Robin Sequence, is characterized by a triad of micrognathia, glossoptosis, and airway obstruction. Glossoptosis involves the tongue falling back into the throat, leading to airway blockage. While Robin Sequence can include a cleft palate, it is not a requirement. Although this condition can be detected via specific ultrasound views before birth, it is often overlooked.
[Dr. Gopi Shah]
When we think about distraction babies, we think about micrognathia and retrognathia. What's the difference? I feel like we get those calls from the NICU and it's like, "This baby looks like their chin's small." We're supposed to go evaluate that. What's the difference? How do I know?
[Dr. Brianne Roby]
Yes. It's funny because I do think, for the most part, on a day-to-day basis, they're fairly interchangeable. If you really want to get down to the nitty-gritty, retrognathia just means that the jaw has a normal size.
It's just a little bit setback. It's like a person with an overbite, right? Which there's lots of kids who needed retainers and braces for having a little bit of an overbite. That's truly retrognathia. It's got everything else that is normal. It's the correct size. It's just a little bit setback.
As opposed to micrognathia where the mandible itself is truly smaller than it should be and smaller comparatively to the maxilla or the upper jaw. It is also retrognathic because if it's micrognathic, it's not going to extend as far and it is going to be setback.
If you look at the overall size of the mandible from micrognathia, it's also just smaller than it should be. That's the true difference. Again, I would say on a day-to-day basis, if you're not down into the nitty gritty, it's oftentimes used interchangeably because if it's setback, is it because the jaw, the whole jaw is smaller or is it just setback a little bit? That's where our specialty can come a little bit into play.
[Dr. Gopi Shah]
On your bedside exam, in terms of it being set back, do you take a ruler? Are there certain millimeter measurements? Is it just, hey, you eyeball it because you've seen enough at this point? How can you tell? They're usually two days old, and I'll be honest, I can't tell. It's so small.
[Dr. Brianne Roby]
I don't take a ruler. What I tend to be looking at is, number one, can you feel their angle of the mandible? Which even in babies with micrognathia, they should have an angle of the mandible. You should be able to feel that angle.
When you start to feel the angle of the mandible and then feel the body of the mandible, in retrognathic babies, they have a really nice size body of the mandible. They don't have any lacking parts and they have a really nice, long body of the mandible.
Whereas in micrognathia, when you feel the angle of the mandible and you start to feel that body, you're like, gosh, there's not much here. It's really small and the whole mandible is just smaller. I think, in terms of doing true measurements, there's nothing really out there on doing true measurements.
If you're trying to get a gauge of things, if you're like, "Wow, this jaw feels like a normal size jaw, it's just a little bit setback compared to the upper one," that's probably retrognathia. If it's truly smaller and there's not much to it in terms of the body of the mandible, that's probably micrognathia.
[Dr. Gopi Shah]
Then the other thing that helps me, is there a cleft palate or not? Can you tell us a little bit about Pierre Robin sequence, and how often is there a cleft palate associated with the sequence?
[Dr. Brianne Roby]
That's such a good question. In terms of Robin sequence, which is technically a triad of micrognathia, glossoptosis, and airway obstruction. Glossoptosis meaning that the tongue is falling back into the airway and causing obstruction.
That's the true definition of the triad of Robin sequence, which if you look at older papers, it was Pierre Robin sequence. If you look at newer papers, we've transitioned to just Robin sequence. I don't know why the change. It's just, in terms of like recent papers I've submitted, they're like, it's now Robin sequence. I'm like, I know, but I'm having a hard time transitioning from Pierre Robin sequence.
If I were to talk to a number of my mentors, the generation just in front of me, many of them would have said that there is no such thing as having Robin sequence without having a cleft palate. That was the modality that I went in with.
The idea that if they didn't have a cleft palate, they didn't truly have Robin sequence. Now looking at the ultimate definition, that's just not correct. You can have Robin sequence without clefting. Numbers show that at least 90% of them do have a cleft palate.
By far and away, most do have a cleft palate, but you could have, usually, probably more in syndromic children, have a micrognathia, glossoptosis, airway obstruction, and no cleft palate. It doesn't necessarily mean that their palate will completely function normally, but they don't have a cleft palate.
[Dr. Gopi Shah]
How often is micrognathia or Pierre Robin diagnosed on ultrasound, prenatal ultrasound? Are you having to do a lot of antenatal counseling? How does that work?
[Dr. Brianne Roby]
It's becoming more and more common. It's still not common. I would say most people with Robin sequence still are not getting diagnosed prenatally. Although you can now, especially on like the higher definition prenatal ultrasound.
If people are getting the really high definition, being 40 now, the 40 ultrasounds, they do something called an inferior facial angle. That's this clue that they may have micrognathia. It's not completely accurate because they're looking at measurements that they may not get the perfect side view or the perfect sagittal view to get that actual measurement.
When they're calling micrognathia on a prenatal ultrasound, it's based on that inferior facial angle, which just has to do with the measurement of basically the angle of the mandible and how long the body of the mandible is after that.
Then they look at the angle of the chin to the angle of the nose. If that's less than 50 degrees, they think that there's concern for micrognathia. If there's a wider angle because the chin to the nose have a greater distance, then it's less likely to be there.
In reality, the only time it's clinically becoming something that we see ahead of time is when they are developing polyhydramnios. In those cases, when the concern for micrognathia is severe enough that they're starting to have polyhydramnios, that tends to be when our maternal fetal medicine will bring it to our conference and discuss ahead of time.
This is concerns for the airway. We're concerned about the severity of the micrognathia. Otherwise, most often what I hear about it is, I see a child in the NICU and when I ask mom about it, they'll be like, "Oh yes, my OB said the jaw or the chin might be a little bit small, but it probably wouldn't be much of anything." We don't often get those prenatal consults.
If we do get the prenatal consults, it's also not in the typical prenatal setting like I see a prenatal cleft lip. It's more often in our maternal fetal medicine comprehensive team, and that's where the maternal fetal medicine doctors will say, "Hey, there's this child. We're a little bit worried about it. Do we need to have ENT present for airway management?"
I can tell you we've never once, for just what is thought to be Robin sequence, done an exit procedure. Now, there are severe cases, a baby that had Nager syndrome and had really no mandible. Those infants, we did do an exit procedure on, but those are picked up at that point. Again, they had polyhydramnios and we ended up getting an MRI ahead of time. The MRI is very sensitive for picking up micrognathia as opposed to just even a three or four dimensional ultrasound.
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Micrognathia Evaluation in the NICU
When the NICU calls about a baby with a small jaw, the first priority is assessing the baby's stability, particularly their airway. The primary concern isn't whether the baby has a cleft palate, but whether the baby is stable or requires immediate intervention. If a baby with a small jaw experiences airway obstruction due to their tongue falling back when lying on their back, repositioning the baby onto their side or stomach can often improve their breathing. Initial assessment focuses on the baby's stability and any minor interventions that have been attempted.
If the baby is relatively stable but experiencing obstructive events, asking about their feeding ability is helpful. For stable babies, it is often advised to wait a few days before performing a flexible scope to get a better sense of the anatomy and any potential airway issues.
In cases where a baby has a small jaw and suspected Robin sequence, it is important to emphasize to the NICU staff not to perform a tongue tie release, as this can worsen airway symptoms rather than help with feeding. Recognizing syndromic features can help determine further management, particularly Treacher Collins or Stickler syndrome, which is commonly associated with Robin sequence. There are other abnormalities, such as choanal atresia, that can cause obstructive symptoms.
It is important to work with NICU nurses to document the baby’s obstructive events, including what triggers them and what interventions are required to stabilize them. This documentation is beneficial if surgical intervention, such as jaw distraction, becomes necessary. Before proceeding with any intervention, a flexible scope should be done to ensure there are no other underlying airway issues, like a molecular cyst, that could complicate the procedure. It is also important to remember that jaw distraction is an airway procedure, not a cosmetic one.
[Dr. Gopi Shah]
Let's say the NICU calls you, and it's a two-day-old maybe term baby with a small jaw. What kinds of questions are you asking them? What are you looking for?
[Dr. Brianne Roby]
The first things I'm looking for are how stable? We're airway doctors, right? The first thing is, who cares if they have a cleft, to be honest? Is the baby stable or do I need to come there emergently? Is this baby, if you put the baby in a different position.
We know that babies with a small jaw, just because of gravity, if their tongue is the thing causing the obstruction, if you put them flat on their back with gravity, their tongue falls back and that causes obstruction.
If you put the baby on their side or on their stomach, do they breathe better? The first thing I'm going to ask is, is the baby stable? If they are stable, what kind of minor interventions can we do? Most often, we just start with positioning.
The other things that I'm going to be asking for are, does this child have any other comorbidities? Do they have other syndromic appearances? Do they have normal ears, normal eyes, normal other way spatial development? Well, micrognathia alone or Robin sequence in isolation is one way of management.
We also know that some of these kids can be with a syndrome such as Treacher Collins or something like that, but all of a sudden their airway management becomes a little bit more complex because they might not just have airway obstruction from glossoptosis. They may have airway obstruction from choanal atresia or other abnormalities.
Those are the first things that I want to know is, how quickly do I need to get there? Is the baby stable or not? What are the things they're able to do to make the child more stable and then syndrome? Those are the immediate, like as I'm even maybe walking down towards the NICU wanting to know right away.
If the baby's relatively stable, but it's just having fairly bad, some obstructive events, the next thing I want to know is, has the baby been able to feed yet? We all know that with babies and feeding, it goes hand in hand.
If a baby has problems with airway obstruction, they are not going to successfully feed. It doesn't matter what the because of airway obstruction is. A baby with airway obstruction is not going to feed successfully. If they're stable from an airway standpoint, the next question is feeding and weight gain. Those are the immediate questions I'm asking about.
[Dr. Gopi Shah]
Let's say the baby is stable, meaning comfortable, lying on his or her back, it's just small jaw. How often are you doing a bedside flex and what are you looking for? Are you doing jaw thrusts during the flex, repositioning?
[Dr. Brianne Roby]
The answer to all of those is yes, but there's a timeline there. If I get called about a baby with micrognathia and concern for Robin sequence, I actually don't bring this scope right away. The reason why is I want to get a sense of the anatomy first. It doesn't mean I won't get the scope, but most often in these kids, I'm actually waiting a little bit of time to scope them.
Not weeks, but maybe a couple of days. The whole thought process for me is having the nurses record, when are they obstructing? How often are they obstructing? With every diaper change, are they going down to oxygen levels of 70% and having to get blow by with every diaper change because they cry? Are they tolerating normal cares and the only time they have events is when they're feeding.
With the initial exam, the first thing I'm doing is just getting a sense of how does their jaw look? How small in comparison? That can be a little bit hard because if you look at a baby just on the side profile, there have been plenty of times where I'm like, holy cow, that jaw looks super small.
Then I look at their gum lines and I'm like, gosh, the distance between their upper and lower alveolus is not that much. It looks more severe on the outside than it does on the inside. Those are things that I'm looking for initially.
Other things that I'm looking at, and this is probably a funny thing, but I've had it be an issue, especially if I get called by an outside NICU, which is they'll be like, well, the baby's pretty micrognathia, but they're also tongue-tied and we think the tongue tie might be affecting their feeding.
When I get that phone call, the first thing I say is absolutely do not do a tongue tie release or frenulotomy in these children. Do not do it. It is not their tongue tie affecting their feeding. It is their airway. Do not do it. You will make their airway worse. I say that because we've had a couple of kids who were teetering by at an outside nursery, newborn nursery or NICU.
Then all of a sudden, someone thought it was the tongue tie and they snipped it. All of a sudden, we actually had much worse airway symptoms and they're getting sent in for worsening airway distress. This isn't so much for the NICUs where I'm at on a day-to-day basis, but for some of the outside ones that we get calls about, it's something that I really do stress.
Also, on the exam, again, I'm looking for other signs of syndromic features. The most common syndrome associated with Robin sequence is Stickler's syndrome. Oftentimes, not always, but oftentimes children with Stickler syndrome have a distinct appearance. They have a little bit flatter, broader nose. Their eyes are a little bit more shallow. They just have this I think the nose is the most telling sign.
It's hard to even describe until you see a couple of, and all of a sudden you're like, wow, without doing any genetic testing, I'm quite sure that child has Stickler syndrome. I'm getting this overall gestalt on the child. Are they syndromic? What else is going on?
Other things to be thinking about is, it's not fully proven yet. Hopefully, maybe someday I'll be in on the data that helps to prove this. We do think that there might be some connection with neonatal abstinence syndrome and Robin sequence.
If a baby is having some airway issues and some obstructive events immediately, within a day or two after life, is it the Robin sequence or are they having withdrawal symptoms from neonatal abstinence syndrome? That can be a little bit, that can take a couple of days to play out and to figure out what's happening.
If they're premature by a couple of weeks, again, is it because they're premature or is it because of the obstruction? This is where I find that really working closely with your NICU nurses, they are your friends. They also can be the hardest nurses because they've been, many of them, doing this for a long time and they know what this baby needs, but they, I truly have gotten them to become in these situations, they're my friends.
I will sit down with them and say, "Look, I need you, every time this baby has an event, to document what triggered it. Were they feeding? Were you changing their diaper? Did you happen to just-- Did they start crying? What happened?
What did you have to do to get them to stop obstructing? Did you have to change their position? Did you have to give them jaw thrust? Did you have to give them oxygen? Did you just wait 10 seconds and the event went away on its own?"
There's not a great place to document this in a chart. At times, the nurse is just doing actually each shift. They'll document how many events and what triggered them. It's worked out really beautifully for me because then I have good documentation if I start to decide that they need more intervention.
It's not me just saying, "Well, I think they would do better with distraction, or I think we need to intervene." I can go to the neonatologist. I can go to the parents and say, "Here's what's happening. Here's the pattern. We can fix this by doing this and this and this."
By having that actually documented, I think it makes it a lot easier, especially I would say early on. If you're new to a facility where they haven't done distractions in the past, and all of a sudden you're waltzing in and you're like, "I have this bright idea to do surgery on a newborn and it's a big jaw distraction surgery and it's going to be great."
They're like, "What the heck are you talking about? Stay away. We want nothing to do with that." You have to be able to come in with some good data and some good documentation as to why you think they need that procedure. That's how I start.
Then getting back to the initial question, I do flexible scope. If I start to think that either, number one, they might need distraction, or number two, they're going to need an intervention of some sort, whether it's distraction or whether it's something else, that's when I will do a bedside flexible scope.
You go through the nose, and then when you get to the nasopharynx, oropharynx, I'm looking to see with them, supine, always very supine. What do I see? In the severe Robin kids, I get into the nasopharynx, and if they have a cleft, it can be a little tricky because often the scope will go through the cleft.
All of a sudden you're like, all I see is the tongue. If they give the jaw thrust, you're like, "Oh, there's the epiglottis. Now I see it." It can be a little bit confusing because, for truly bad glossoptosis, it's not that you're seeing tongue base, you're actually seeing the tip of the tongue.
That tongue flops back so much and perpendicular that you look in there and you're like, "Is that the epiglottis or the tip of the tongue?" Then they give a jaw thrust and you're like, "Oh, that was the tongue. There's the epiglottis," and you can see it down below. I absolutely do a flexible scope.
Again, for a variety of reasons. I don't want to be surprised if we went to do a distraction and lo and behold, they had a molecular cyst too, or they had something abnormal on their vocal cord and I hadn't even noticed or acknowledged that ahead of time.
I think you want to make sure that you've dotted your I's and crossed your T's in terms of airway. Again, as a surgeon that does jaw distraction, mandibular distraction, it's an airway procedure, right? It is not a cosmetic procedure.
It is not a, this will help for how their jaw appearance looks later. It is a airway procedure. You have to think like an airway surgeon and be thinking and making sure there's nothing else from an airway that you should be dealing with.
How to Determine if a Small Jaw or a Large Tongue is Causing Airway Obstruction
Determining whether a large tongue is causing airway obstruction in infants can be challenging, especially when it's unclear if the obstruction is due to a small jaw or simply a large tongue. According to Dr. Brianne Roby, a key distinction lies in observing whether the entire tongue is falling back into the airway (glossoptosis) or if it's just the tongue base that appears enlarged. For example, in children with conditions like trisomy 21, which often involves a larger tongue, the obstruction may be due to the tongue base rather than the entire tongue collapsing.
Using a jaw thrust during a flexible scope can help differentiate between these scenarios. If the jaw thrust reveals that the whole tongue is collapsing backward, it's likely glossoptosis. However, if only the tongue base appears large without the entire tongue falling back, the issue may be due to the size of the tongue itself rather than jaw position. This distinction can help in determining the appropriate management approach, such as whether jaw distraction surgery would be beneficial.
[Dr. Gopi Shah]
On your scope, and sometimes I struggle with this because, again, sometimes it's hard to tell if the baby truly has a small jaw or not, or if their airway obstruction is, hey, the tongue is just big. They've got to grow out of their tongue. Did I make that up in my head or do you find babies that have such bad airway obstruction because their tongue is just big? How can you tell the difference in your initial evaluation?
[Dr. Brianne Roby]
I think, again, the way that you can really tell is, are you seeing just tongue base or are you seeing the entire tongue fall back? That's where your nurses are your friends in terms of that jaw thrust. For instance, a child with trisomy 21, for instance, they have big tongues, a lot of them, even as newborns.
Beckwith-Wiedemann, not so much because that's anterior tongue and not the back of the tongue. For a trisomy 21 kid, if you scoped them and you saw their tongue base, you're not going to be like, oh, jaw distraction is going to help them.
I think that's where the jaw thrust really helps because you can get a sense of whether it's just the tongue base that's big or whether it is the whole tongue. Seeing the tip of the tongue all the way back in the oral pharynx, so it gives you that clue that it's truly glossoptosis.
What I will do is, once I get the scope in there, sometimes I need that jaw thrust to help figure it out. Then you let go of the jaw thrust, and you can be looking at the epiglottis, and then if you're right at the level of the vocal cords and slowly back out and get a sense of, is the whole tongue backwards or is this just a big tongue?
I think just a big tongue, the whole thing isn't going to collapse on you. You're just going to see the tongue base. Whereas if it's truly glossoptosis, the whole tongue just collapses all the way back. I think that's the distinct difference.
Sleep Disordered Breathing in Micrognathia
When assessing sleep-disordered breathing in infants with micrognathia, the approach to using sleep studies varies by institution. Dr. Brianne Roby explains that while some clinicians rely on sleep studies, her practice does not typically involve them. The reasoning is that sleep studies capture infants at their best, often missing the moments of greatest symptom severity, such as during feeding or when the child is agitated. Instead, Dr. Roby prefers to monitor CO2 levels, particularly in symptomatic infants, as they can be a more telling indicator of chronic hypoventilation, which helps guide decisions about interventions.
Sleep studies may be used in specific cases, such as older children who have outgrown the newborn phase without requiring early intervention but later present with sleep-related symptoms. In such instances, sleep studies can assist in determining whether jaw distraction is necessary. However, the use of sleep studies in newborns remains controversial, as the data may not be as reliable for this age group, and the results could potentially lead to unnecessary or premature interventions.
[Dr. Gopi Shah]
Then you'd mentioned, so we talked about, how are they breathing, how are they feeding, and then obviously sleep-disordered breathing. How are they breathing when they sleep? Is there a role for sleep studies in these infants? I want to say no, but I don't know. is there a role for sleep study or apnea monitors or if they're symptomatic, you have a reason?
[Dr. Brianne Roby]
The answer is, depending on your institution, some people really like sleep studies and some of us do not get them. We do not get them at my institution. Getting an inpatient sleep study is hard. We can do it.
More often than not, we're probably going to get just an infant apnea-type test instead. The reason I don't get a sleep study is that, in my mind, for these kids, if you get a sleep study, you're getting them at their best, right?
These kids tend to be at their best while they're sleeping, and they tend to have their most symptoms either when they're agitated, crying, or feeding. Why would I make my ultimate decision-making on a child when they're at their best instead of when they're either at their most likely or their worst? We do not get sleep studies.
I do get cap gases in these kids. I find that extremely helpful. I usually will get a cap gas within, if they're already symptomatic, within 24 hours. If they're not super symptomatic, usually within 24 to 48 hours. Then we'll follow it every couple of days to show if they're chronically hypoventilating and have elevated cap gas CO2 levels.
I think that's a better indicator for me for doing distraction than a sleep study. Now, there are some institutions that do get sleep studies on all of their patients before they distract them. It's not a right or a wrong. I think it primarily does have to do with your thoughts on would it change my management?
To me, if it's a positive sleep study, then if we do what I'm already telling you, I have my nurses do documenting that they obstruct, that they need interventions, that they're not feeding well. Those are probably already positive and already being documented. The sleep study doesn't help me there.
If it's negative, my response is going to be, well, it's while they're at their best, so I also don't care. That's why I don't get a sleep study. Again, I think if you go around the country, it's probably a mixed bag on that. Certainly not a right or a wrong. It just has to do with what your comfort level is.
[Dr. Gopi Shah]
Yes. Whether it's a baby for distraction or not, I feel like an infant, especially under six months, we don't have great normative data. We're going to get HIs of 50 to 100 an hour. Then if they can't get distracted, now we've set a baby up for a trait. Anyways–
[Dr. Brianne Roby]
Yes, well, that's exactly it. That's the thing. It's not validated for newborns. Depending on who reads your sleep studies, they may feel more or less comfortable with it. I will tell you, the kids that I find sleep studies are helpful. This is in a whole different population than what we're talking about, but it's in the Robin kids who maybe skimmed by and didn't need distraction at age three months or as a newborn.
All of a sudden, they're 18 months, and you thought that their mandible was going to catch up with its growth, and it never really caught up, and parents are describing some sleep symptoms. You're like, okay, now what am I going to do with this kid?
[Dr. Gopi Shah]
Yes. What do you do?
[Dr. Brianne Roby]
I do get a sleep study.
[Dr. Gopi Shah]
Are you doing a distraction or a TNA in that 18-month-old with an HI of 15 an hour, let's just say.
[Dr. Brianne Roby]
Yes. I think it depends. If I don't think it's due to the micrognathia, then obviously I would do jaw distraction. If they have minimal tonsil, minimal adenoid, you scope them and they have just this glossoptosis, that kind of thing, I will do jaw distraction on them.
It's far less. Out of all the kids I distract, it is so much less. Those are the kids where I've gotten sleep studies, and I find it helpful and pushing me to make the final decision.
Podcast Contributors
Dr. Brianne Roby
Dr. Brianne Roby is a pediatric otolaryngologist with Children's Minnesota and assistant professor at the University of Minnesota Medical School.
Dr. Gopi Shah
Dr. Gopi Shah is a pediatric otolaryngologist and the co-host of BackTable ENT.
Cite This Podcast
BackTable, LLC (Producer). (2021, December 14). Ep. 39 – Evaluation & Management of an Infant with a Small Jaw [Audio podcast]. Retrieved from https://www.backtable.com
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
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