Nasopharyngoscopy in Robin Sequence: Clinical and Predictive Value

Abstract

A poor correlation between the severity of glossoptosis and the severity of clinical manifestations was observed for patients with respiratory obstruction caused by glossoptosis during the first month of life, but the correlation between glossoptosis and respiratory distress according to age was statistically significant. Nasopharyngoscopy is not a good method for predicting the severity of the clinical course of respiratory obstruction caused by glossoptosis.

Seqüência de Robin: protocolo único de tratamento

“…However, no statistically significant correlation was observed between severity of glossoptosis and severity of clinical manifestations in the neonatal period. 9 The same patients prospectively followed up until the end of their first year of life by way of nasopharyngoscopy and clinical examination showed less severe glossoptosis and less severe clinical manifestations with the advance of age; the correlation between advanced age and reduction of glossoptosis was statistically significant. These infants were virtually asymptomatic at six months of age.…”

“…[4][5][6][7][8][9] The article concludes by proposing a single treatment protocol, which can be applied to all RS cases.…”

“…Despite reduction of the posterior displacement of the tongue, at the age of one year, some infants had moderate or severe glossoptosis, but were asymptomatic. 9 With regard to other types of obstruction, infants with type 2 obstruction in the neonatal period presented with type 1 obstruction at the end of the first year, with mild clinical manifestations, whereas infants with type 3 or 4 showed the same type of obstruction throughout their first year of life, having to live with a tracheostomy, with no possibility of decannulation. 9 Figure 5 -U-shaped cleft palate During the neonatal period, nasopharyngoscopy was an important procedure for the diagnosis of the type of airway obstruction and for the planning of RS treatment; therefore, to define the prognosis of the severity of airway obstruction and of clinical outcome, nasopharyngoscopy is important only when the different types of obstruction are compared, with a worse prognosis for types 3 and 4.…”

“…9 With regard to other types of obstruction, infants with type 2 obstruction in the neonatal period presented with type 1 obstruction at the end of the first year, with mild clinical manifestations, whereas infants with type 3 or 4 showed the same type of obstruction throughout their first year of life, having to live with a tracheostomy, with no possibility of decannulation. 9 Figure 5 -U-shaped cleft palate During the neonatal period, nasopharyngoscopy was an important procedure for the diagnosis of the type of airway obstruction and for the planning of RS treatment; therefore, to define the prognosis of the severity of airway obstruction and of clinical outcome, nasopharyngoscopy is important only when the different types of obstruction are compared, with a worse prognosis for types 3 and 4. When the intention is to establish the prognosis of the severity of type 1 obstruction, nasopharyngoscopy is not a good method, probably due to the intrinsic activity of the genioglossus muscle, which pulls the tongue forward; since it is a static test, nasopharyngoscopy is not able to measure this parameter.…”

“…Nasopharyngoscopic findings were correlated with prognosis and type of treatment. 2,9 Type 1, which truly represents glossoptosis as the cause for airway obstruction, is the most frequent type observed in RS. 2,4,5 Studies carried out at HRAC-USP revealed that this type of obstruction occurs in 80% of the cases.…”