Non-surgical management of Pierre Robin syndrome.

Pielou, W D

doi:10.1136/adc.42.221.20

Cited by 37 publications

(15 citation statements)

References 8 publications

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“…6,[22][23][24][25] Other nonoperative treatment options include oxygen supplementation, CPAP, NPA, and intubation. 1,[26][27][28][29][30] The NPA, one of the most common nonoperative interventions for infants with RS in Europe, 13 was recommended less frequently (47%) in this survey. There was a trend toward more use of the NPA by non-US respondents, but this was not statistically relevant.…”

Section: Discussionmentioning

confidence: 92%

Early Management of Infants With Robin Sequence: An International Survey and Algorithm

Resnick

LeVine

Calabrese

et al. 2019

Journal of Oral and Maxillofacial Surgery

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There is no widely accepted protocol for management of infants with Robin sequence (RS) who present with airway obstruction and feeding impairment. The purposes of this study were to evaluate diagnostic and treatment preferences of clinicians from the United States and non-US countries and to use these data to propose an algorithm for early management of infants with RS.Materials and Methods: A cross-sectional study was implemented using a survey, which was distributed to craniofacial surgeons and non-surgeon physicians involved in management of infants with RS. Predictor variables were nationality, specialty, and surgical volume. Outcome variables included survey responses regarding preferences for evaluation and early treatment of patients with RS. A diagnostic and early treatment algorithm was proposed based on the most common survey responses. Descriptive and analytic statistics were calculated and a P less than .05 was considered significant.Results: A total of 275 responses were received and 82 were excluded, leaving a final sample of 193 participants: 155 (80%) surgeons and 38 (20%) non-surgeon physicians. Thirty-seven US states were represented by 143 (74%) respondents and 50 (26%) participants were from 19 non-US countries. There were 96 (50%) low-volume and 97 (50%) high-volume respondents. There was general agreement in methods for evaluation and early treatment among respondents; the only significant differences were 1) US surgeons operate earlier to address airway obstruction than those from other countries (P = .001), 2) high-volume providers tend to operate earlier (P = .017) and to choose mandibular distraction more frequently (P = .003) than low-volume respondents, and 3) mandibular distraction is the preferred operation in the United States, but several operations for airway improvement are used equally in non-US countries (P < .001). Conclusion:Despite variation in the evaluation and treatment of infants with RS, this international and multispecialty survey showed trends that could represent best practices. An algorithm based on these findings is proposed.

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Section: Discussionmentioning

confidence: 92%

Early Management of Infants With Robin Sequence: An International Survey and Algorithm

Resnick

LeVine

Calabrese

et al. 2019

Journal of Oral and Maxillofacial Surgery

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“…Oral appliances have been used for over 40 years in RS to facilitate bottle feeding and to keep the tongue out of the cleft 9. Within a median hospital stay of 19 days, the proportion of infants needing nasogastric tube feeding could be reduced from 66% upon admission to 8% at discharge, suggesting that PEBP treatment may indeed facilitate oral feeding.…”

Section: Discussionmentioning

confidence: 99%

“…Prone positioning, which is reported effective for many RS infants, has never been investigated objectively, that is, based on sleep study results. A functional treatment option is based on an intra-oral orthodontic appliance with a velar extension 9. Our group has further developed this appliance, which now has a long velar extension shifting the dorsum of the tongue forward, thereby widening the pharyngeal space (pre-epiglottic baton plate (PEBP); figures 1 and 2).…”

Section: Introductionmentioning

confidence: 99%

Functional treatment of airway obstruction and feeding problems in infants with Robin sequence

Buchenau

Wenzel

Bacher³

et al. 2016

Arch Dis Child Fetal Neonatal Ed

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“…Genetic testing is highly recommended for these patients because the pathogenesis of this condition can be multifactorial and syndromic in nearly half of the occurrences of PRS 1,[4][5][6][7][8] . Breathing impairment is a major problem in patients with PRS [9][10][11] . The assessment of the impairment is based on clinical parameters (episode of desaturation, spontaneously and during feeding and sleep) and growth of facial structures during the first two years of life [9][10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

“…Breathing impairment is a major problem in patients with PRS [9][10][11] . The assessment of the impairment is based on clinical parameters (episode of desaturation, spontaneously and during feeding and sleep) and growth of facial structures during the first two years of life [9][10][11][12] . Many clinicians suggest treating mild cases with prone positioning using special "sniffing air" beds or other non-invasive respiratory support 13 .…”

Section: Introductionmentioning

confidence: 99%

Semi-Automatic Volumetric Segmentation of the Upper Airways in Patients with Pierre Robin Sequence

et al. 2014

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Non-surgical management of Pierre Robin syndrome.

Cited by 37 publications

References 8 publications

Early Management of Infants With Robin Sequence: An International Survey and Algorithm

Early Management of Infants With Robin Sequence: An International Survey and Algorithm

Functional treatment of airway obstruction and feeding problems in infants with Robin sequence

Semi-Automatic Volumetric Segmentation of the Upper Airways in Patients with Pierre Robin Sequence

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