Treatment of infants with Syndromic Robin sequence with modified palatal plates: a minimally invasive treatment option

Autor: Silvia Müller-Hagedorn, Wolfgang Buchenau, Jörg Arand, Margit Bacher, Christian F. Poets
Rok vydání: 2016
Předmět:
Male
Palate
Hard
Databases
Factual
medicine.medical_treatment
Polysomnography
medicine.disease_cause
Severity of Illness Index
Orthodontics
Corrective
Positive-Pressure Respiration
0302 clinical medicine
Child Development
Germany
Laryngomalacia
Continuous positive airway pressure
Child
medicine.diagnostic_test
Pierre Robin Syndrome
Upper airway obstruction
Syndromic Robin sequence
Treatment Outcome
Child
Preschool
Pierre Robin syndrome
Female
Orthodontic treatment
Nasal cannula
medicine.medical_specialty
lcsh:Specialties of internal medicine
Oral appliance
Clinical Neurology
Prosthesis Design
Risk Assessment
03 medical and health sciences
Sleep Apnea Syndromes
Orthodontic Appliances
lcsh:RC581-951
030225 pediatrics
medicine
Humans
Palatal plate
General Dentistry
Retrospective Studies
business.industry
Dentistry(all)
Research
Infant
030206 dentistry
Airway obstruction
Length of Stay
medicine.disease
Surgery
Obstructive sleep apnea
Otorhinolaryngology
Neurology (clinical)
business
Follow-Up Studies
Zdroj: Head & Face Medicine
Head & Face Medicine, Vol 13, Iss 1, Pp 1-9 (2017)
ISSN: 1746-160X
Popis: Background Infants with Robin sequence (RS) suffer from upper airway obstruction (UAO) and feeding problems. We developed an oral appliance with a velar extension in combination with functional treatment and appropriate feeding techniques, which was proven effective in isolated RS. As the above problems are particularly challenging in syndromic RS, we set out to evaluate our treatment concept also in these patients. Methods We searched our electronic departmental database to identify all children admitted to our department between 01/01/2003 and 31/12/2009 because of syndromic RS. UAO was quantified by cardiorespiratory sleep studies performed before and during treatment with a modified palatal plate. This appliance consists of a palatal part, covering the hard palate as well as the alveolar ridges and the potential cleft, and a velar extension shifting the tongue in a more anterior position, thereby opening the pharyngeal airway. It is adjusted by fiberoptic nasopharyngoscopy and controlled by cardiorespiratory sleep studies. Obstructive sleep apnea was defined as a mixed obstructive sleep apnea index (MOAI) >3/h. Feeding modalities before and after treatment and weight gain, determined as standard deviation score, were also evaluated. Results Of 68 children meeting inclusion criteria, 56 completed treatment (46 of these being infants). Underlying diagnoses included craniofacial dysostosis (N = 13) and synostosis syndromes (N = 5), unspecified dysmorphic syndromes (N = 23) and miscellaneous rare conditions (N = 27). Median MOAI decreased from 8.5 (range 0.3–76.0) at admission to 1.1 (0.0–5.2) at discharge (p
Databáze: OpenAIRE
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