Neonates with Tongue‐Based Airway Obstruction

Bookman, Laurel; Melton, Kristin; Pan, Brian S.; Bender, Patricia; Chini, Barbara A.; Greenberg, J. M.; Saal, Howard M.; Taylor, Jesse A.; Elluru, Ravindhra G.

doi:10.1177/0194599811421598

Cited by 48 publications

(38 citation statements)

References 134 publications

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“…Underscoring the lack of evidence for MDO, Bookman et al 23 conducted a systematic review of the literature regarding the diagnosis, treatment, and outcomes of neonatal TBAO. They found that most studies conducted on TBAO were case studies and singlecenter findings lacking standardized diagnostic and treatment protocols.…”

Section: Discussionmentioning

confidence: 99%

Mandibular Distraction Osteogenesis for the Treatment of Neonatal Tongue-Based Airway Obstruction

Goldstein

Chung²,

Paliga³

et al. 2015

Journal of Craniofacial Surgery

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Early postnatal tracheostomy for airway compromise is associated with high morbidity and cost. In certain patients with tongue-base airway obstruction (TBAO), mandibular distraction osteogenesis may be preferred. We present a comprehensive analysis of surgical, airway, and cephalometric outcomes in a large series of neonatal patients with TBAO. A retrospective review was performed of patients with laryngoscopically proven TBAO who underwent mandibular distraction osteogenesis before 1 year of age at our institution. Demographic, operative, postoperative, polysomnographic, and radiographic data were analyzed with the appropriate statistical test. Between 2010 and 2013, 28 patients younger than 1 year underwent mandibular distraction for TBAO. Distraction was performed for documented TBAO and failure to thrive at an average age of 58 days (range, 11-312) days with distractor removal after an average of 90 days. Preoperative polysomnograms were obtained on 20 patients with an average apnea-hypopnea index of 39.3 ± 22.0/h; the apnea-hypopnea index on postoperative polysomnograms obtained after distraction completion was significantly reduced in all 14 patients in whom it was measured (mean, 3.0 ± 1.5/h; P < 0.0001). Twenty patients transitioned to oral feeding, and cephalometric and airway diameters were improved (P < 0.0001). Distraction was successful in all but 4 patients including all patients with GILLS scores of 2 or less and 66% of patients with GILLS scores of 3 or greater. Neonatal mandibular distraction is a powerful tool to treat critical obstructive apnea in patients with TBAO. Appropriate patient selection remains a challenge; however, mandibular distraction represents a compelling treatment modality.

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Section: Discussionmentioning

confidence: 99%

Mandibular Distraction Osteogenesis for the Treatment of Neonatal Tongue-Based Airway Obstruction

Goldstein

Chung²,

Paliga³

et al. 2015

Journal of Craniofacial Surgery

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“…Indeed, a systematic review of all current evidence in the literature regarding diagnosis, treatment, and long-term outcomes in neonates with Pierre Robin sequence found little evidence beyond expert opinion and single-center evaluation, with lack of standardization of diagnostic and treatment protocols. 30 The overall lack of clinical comparative data combined with the ongoing debate over the benefit of tongue-lip adhesion versus mandibular distraction led to the pursuit of this report.…”

Section: Discussionmentioning

confidence: 99%

The Surgical Correction of Pierre Robin Sequence

Flores

Tholpady

Sati

et al. 2014

Plastic &Amp; Reconstructive Surgery

115

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“…Conditions that include micrognathia are thought to cause OSAS due to obstruction at the base of the tongue from glossoptosis and reduced oropharyngeal airway size 25 .…”

Section: Osas In Craniofacial Conditionsmentioning

confidence: 99%

Obstructive sleep apnoea in children with craniofacial syndromes

Cielo

Marcus

2015

Paediatric Respiratory Reviews

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Summary Obstructive sleep apnoea syndrome (OSAS) is common in children. Craniofacial anomalies such as cleft palate are among the most common congenital conditions. Children with a variety of craniofacial conditions, including cleft palate, micrognathia, craniosynostosis, and midface hypoplasia are at increased risk for OSAS. Available evidence, which is largely limited to surgical case series and retrospective studies, suggests that OSAS can be successfully managed in these children through both surgical and non-surgical techniques. Prospective studies using larger cohorts of patients and including polysomnograms are needed to better understand the risk factors for this patient population and the efficacy of treatment options for OSAS and their underlying conditions.

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Neonates with Tongue‐Based Airway Obstruction

Cited by 48 publications

References 134 publications

Mandibular Distraction Osteogenesis for the Treatment of Neonatal Tongue-Based Airway Obstruction

Mandibular Distraction Osteogenesis for the Treatment of Neonatal Tongue-Based Airway Obstruction

The Surgical Correction of Pierre Robin Sequence

Obstructive sleep apnoea in children with craniofacial syndromes

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