Xiao Wang’s baby was born, and the whole family was very happy. But the grandparents and grandparents who were waiting outside the delivery room did not see the baby right away. The doctor told them that the baby was suffering from a congenital disease called Piro Sequence, and had some difficulty in breathing and swallowing, and was under observation in the NICU. Now several elderly people were anxious and did not know what to do. The doctor said, “Don’t worry too much, let’s take a look at the baby through the monitor. Everyone followed the doctor to a TV, only to see a pink, weak baby, lying on its side in the incubator. With the rhythm of breathing, the child’s little head little by little. At this point the grandmother turned to the grandfather and whispered, “Look at his chin, it seems a little ……” Several elderly people came closer to the TV for a while, and their eyes turned to the doctor. The doctor looked around at the seniors and said, “His chin does seem to be developing small, which is why we are considering him to have the Piro sequence sign. There are three main features of the Pirro Sequence: small jaw, posterior tongue drop and airway obstruction. These three major manifestations of the Pirro Sequence are intertwined: a too-small jaw pushes the tongue back, and the tongue obstructs the pharyngeal airway backwards. A newborn infant will exhibit an underdeveloped jaw and respiratory distress (e.g., nodding-like breathing, trigeminal sign). Such infants often have a cleft palate and a wide U-shaped cleft palate. In addition to this, the child may have other craniofacial anomalies, cardiovascular anomalies, etc. Children with the Pirosequential sign undergo a multidisciplinary evaluation, which includes the anatomical features of the maxillofacial region, the cause and specific location of airway obstruction, airway care and feeding practices. Nearly 70% of children with the condition improve their airway obstruction by adjusting their position. The use of the correct position also allows most children to eat normally. If the child has problems with oxygen saturation, a nasopharyngeal ventilation tube may have to be inserted. Early nasogastric feeding with a nasogastric tube helps the child to replenish energy and gain weight early. For a certain percentage of children, conservative treatment does not work and further surgical treatment is needed. However, before any surgery is done, the surgeon must do an airway evaluation. Because some airway obstructions are below the base of the tongue, only a tracheotomy can be performed to resolve the problem. There are two main surgical treatments available: a labiolingual adhesion and a distraction osteotomy.