Weight gain in infants with Pierre Robin sequence

Tomic, Josip; Metzler, Philipp; Alcon, Andre; Jakse, Norbert; Zemann, Wolfgang; Schanbacher, Monika; Zrnc, Tomislav

doi:10.1016/j.jcms.2020.03.009

Cited by 7 publications

(5 citation statements)

References 23 publications

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“…The non-surgical methods such as nasopharyngeal tubes, modified palatal plate, and prolonged intubation with supplemental oxygen have shown improvements in weight gain and air way obstruction. However, these measures are proven less effective in infants with moderate and severe respiratory distress or where immediate weight gain is required [7]. In such cases, surgical interventions such as tongue-lip adhesion, MDO, and tracheostomy are used.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Timing of Mandibular Distraction Osteogenesis on Weight Velocity in Infants Affected by Severe Robin Sequence

et al. 2022

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Background: Impaired weight gain is prevalent in Robin Sequence (RS) newborns. Although mandibular distraction osteogenesis (MDO) has been proven to improve oral feeding, its impact on postoperative weight gain remains unclear. The purpose of this study is to explore whether MDO can help RS babies reach a normal weight, as well as the effect of MDO timing on weight velocity. Methods: One hundred infants with severe RS and one hundred with normal controls met the inclusion criteria for the study. Included patients underwent MDO. Weights at different timing points were recorded and analyzed and compared to normal controls. Results: After the distractor removal weights of patients undergoing MDO at <1 month and 1–2 months were close to the normal control (6.81 ± 0.93 kg versus 7.18 ± 0.61 kg, p = 0.012, and 6.82 ± 0.98 kg versus 7.37 ± 0.75 kg, p = 0.033, respectively), the weights of patients undergoing MDO at 2–3 months and 3–4 months still lagged behind (7.56 ± 1.29 kg versus 8.20 ± 0.61 kg, p = 0.000206 and 7.36 ± 1.05 kg versus 8.25 ± 0.77 kg, p = 0.004, respectively). The weights of all RS infants undergoing MDO showed no significant difference compared to the controls when they aged to 1 year (9.34 ± 0.99 kg versus 9.55 ± 0.45 kg, p = 0.254 for MDO at <1 month; 9.12 ± 0.91 kg versus 9.33 ± 0.46 kg, p = 0.100 for MDO at 1 to 2 months; 9.38 ± 0.29 kg versus 9.83 ± 0.53 kg, p = 0.098 for MDO at 2 to 3 months; and 9.38 ± 0.29 kg versus 9.83 ± 0.53 kg, p = 0.098 for MDO at 3 to 4 months). Conclusion: The MDO procedure helped patients with severe RS to reach a normal weight; and MDO intervention was recommended at an early stage for early weight gain.

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Section: Introductionmentioning

confidence: 99%

The Effect of Timing of Mandibular Distraction Osteogenesis on Weight Velocity in Infants Affected by Severe Robin Sequence

et al. 2022

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“…This study showcased the ability for MDO to relieve UAO and prevent tracheostomy while also permitting appropriate weight gain without the use of feeding tubes. Findings from 2 other retrospective studies suggest that MDO may promote normal feeding by relieving gastroesophageal reflux disease and swallowing function 23,24 . Moreover, the avoidance of an additional surgical intervention and decreased time needed for a feeding tube are potential benefits for quality of life 1,17 …”

Section: Discussionmentioning

confidence: 99%

“…Findings from 2 other retrospective studies suggest that MDO may promote normal feeding by relieving gastroesophageal reflux disease and swallowing function. 23,24 Moreover, the avoidance of an additional surgical intervention and decreased time needed for a feeding tube are potential benefits for quality of life. 1,17 Traditionally, managing AO conservatively with CPAP or prone positioning is prioritized over addressing feeding dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Mandibular Distraction Osteogenesis as a Primary Intervention in Infants With Pierre Robin Sequence

et al. 2021

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Background Pierre Robin sequence (PRS) is a triad of congenital facial abnormalities that can present as a syndrome (syndromic PRS [sPRS]) or an isolated entity (isolated PRS [iPRS]). Patients with PRS can develop airway and feeding problems that may result in failure to thrive. Mandibular distraction osteogenesis (MDO) is a method for improving the functional issues associated with breathing and feeding. There is a Paucity of literature evaluating the outcomes of MDO between sPRS and iPRS patients. Methods An institutional review board–approved retrospective review of PRS patients managed by a single surgeon and treated with MDO between January 2015 and December 2019 at a tertiary referral hospital was performed. The patients were stratified into iPRS or sPRS based on gene testing. Airway outcome measures included avoidance of tracheostomy, relief of sleep apnea, and oxygen saturation improvement. Primary feeding measures included achievement of full oral feeds and growth/weight gain. Statistical analysis included t tests and χ2 tests where appropriate using SPSS. Results Over the study period, of the 29 infants with PRS, 55% identified as iPRS and 45% as sPRS. There were no significant differences in the patient characteristics, apnea-hypoxia index (22.27 ± 12.27) and laryngeal view (3 ± 0.79) pre-MDO. After MDO, 83% of the subjects achieved a positive feeding outcome and 86% achieved a positive airway outcome with no statistical significance between sPRS and iPRS (P = 0.4369). There was a statistically significant change post-MDO in apnea-hypoxia index (5.24 ± 4.50, P = 0.02) and laryngeal view (1.59 ± 1.00, P = 0.01). Conclusions Our recent experience would lead us to believe that sPRS patients have greater morbidities and challenging clinical developments that, when properly evaluated, can be managed by MDO. There is a potential role for MDO in reducing the need for traditional surgical interventions for respiratory and feeding problems in both iPRS and sPRS patients.

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“…Otra alternativa no quirúrgica es la placa palatina modificada. Este dispositivo con extensión velar de aproximadamente 3 mm 20 , se coloca endoscópicamente en el recién nacido para lograr el recubrimiento del paladar hendido; ensancha la hipofaringe, reduce las complicaciones respiratorias después del cierre de hendiduras palatinas 28 , induce la posición anterior y horizontal de la lengua, alivia la obstrucción de vías aéreas y mejora la alimentación por el estímulo que genera en la succión y deglución. Generalmente necesita de desgastes y cremas fijadoras para mantenerse in situ 29 .…”

Section: Revisión De La Literaturaunclassified

Manejo multidisciplinario de las alteraciones maxilofaciales asociadas al Síndrome de Pierre Robin. Revisión de literatura

Cerda Sánchez,

Astorga,

García

2024

J Multidiscip Dent

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Establecer la secuencia del manejo terapéutico de las alteraciones maxilofaciales asociadas al Síndrome de Pierre Robin en intervención multidisciplinaria, mediante una revisión de literatura entre el año 2016 y 2021. La investigación realizada para el presente artículo es de tipo descriptivo, estableciendo como muestra artículos publicados del año 2016 al 2021, recolectados en la base de PubMed y Google Académico, empleando los términos de búsqueda, Pierre Robin Syndrome, Maxillofacial Abnormalities, Surgical Procedures, Operative, combinados con los conectores booleanos AND y sus homólogos en español. Se estableció como estrategia PICO la búsqueda ((Pierre Robin Syndrome) AND (Maxillofacial Abnormalities)) AND (Surgical Procedures, Operative) que arrojó 14 artículos en PubMed y 951 artículos en Google Académico. Se consideraron como criterios de inclusión revisiones sistemáticas, metaanálisis, revisiones bibliográficas y casos clínicos, que traten sobre el Síndrome de Pierre Robin y su manejo quirúrgico. Los criterios de exclusión fueron libros, monografías, estudios experimentales; que permitieron obtener artículos de PubMed y 29 de Google académico. Cada resultado se digitó en un diagrama de flujo. Cada artículo fue analizado en su totalidad. Fueron almacenados en un archivo digital. La historia clínica, examen físico, hospitalización en UCI para monitoreo continuo, realizar exámenes diagnósticos complementarios, el abordaje conservador y/o quirúrgico determinada por el nivel de obstrucción de la vía aérea constituyen la secuencia idónea sugerida por varios autores para el manejo de las alteraciones maxilofaciales del Síndrome de Pierre Robin.

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Weight gain in infants with Pierre Robin sequence

Cited by 7 publications

References 23 publications

The Effect of Timing of Mandibular Distraction Osteogenesis on Weight Velocity in Infants Affected by Severe Robin Sequence

The Effect of Timing of Mandibular Distraction Osteogenesis on Weight Velocity in Infants Affected by Severe Robin Sequence

Mandibular Distraction Osteogenesis as a Primary Intervention in Infants With Pierre Robin Sequence

Manejo multidisciplinario de las alteraciones maxilofaciales asociadas al Síndrome de Pierre Robin. Revisión de literatura

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