There are several treatment options for Piro Sequential Syndrome, these are as follows: The first category of treatment options is non-surgical treatment. Postural adjustments: About 70% of children with Piro Sequential Signs can improve their sleep breathing problems by adjusting their sleeping position, such as lying on their side or prone. The same is true for feeding, and some children can even be treated without other treatments by postural adjustments. However, if it is difficult to find a suitable sleeping and feeding position, you should ask your doctor to use other methods. Nasopharyngeal ventilation tube: A nasopharyngeal ventilation tube is a semi-rigid, curved tube that is inserted through the nostril and leads straight to the pharyngeal cavity for the purpose of ventilation. Different children need different sizes and types of ventilation tubes. Usually more than 2 tubes are needed, which are cleaned and used alternately, and are usually placed for 2 to 4 months. Nasal tube feeding: Feeding is also very important for children with Piro sequence sign because Piro sequence sign can cause swallowing difficulties. If the child has a cleft palate, swallowing difficulties are more pronounced. Difficulty in swallowing often causes choking and coughing, and even pneumonia. Once sick, the child may lose weight instead of gaining it. With a nasal feeding tube, the ideal weight gain can be 25 g/day, or 1.5 pounds a month. A proportion of children with Piro syndrome will require surgery if non-surgical treatment does not work. Therefore, the second category of treatment modalities, is surgical treatment. 1. Labiolingual adhesions: Labiolingual adhesions were invented in 1911 and involve sewing the tip of the tongue and the lower lip together to force the tongue outward to alleviate the problem of a receding tongue. This procedure can only be done until the lower milk teeth come in, and once they do, the tongue will be worn down. At that time, another surgery will have to be done to separate the tongue from the lower lip. Also, even with this procedure, the relief of respiratory disturbances is limited to 38%. Retraction osteotomy: Retraction osteotomy was invented by McCarthy in 1989. It is now recognized as the best treatment for Pirro’s syndrome and can completely resolve the problems of airway obstruction, maxillofacial deformity, and malocclusion in Pirro’s syndrome. This procedure elongates the child’s overly small jaw, allowing the jaw to elongate from its retracted position, the tongue to move forward, and the airway to open up. 2. Brief requirements for distraction osteogenesis: the child is at least 1 month old, weighs more than 3.5 kg, and has no major co-morbidities; he can be monitored in the hospital if he has other diseases or obvious breathing or swallowing difficulties; sleep monitoring, CT 3D reconstruction, cardiac ultrasound, and model surgery should be done and designed before the operation; the distraction needs to be surgically removed 2~3 months after the operation.