The Surgical Correction of Pierre Robin Sequence

Flores, Roberto L.; Tholpady, Sunil S.; Sati, Shawkat; Fairbanks, Grant; Socas, Juan; Choi, Matthew; Havlik, Robert J.

doi:10.1097/prs.0000000000000225

Cited by 115 publications

(49 citation statements)

References 31 publications

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“…Early studies of MDO in young children reported high rates of clinical resolution of symptoms 40 and subsequent studies involving PSG have shown substantial improvement in OSAS in the majority of patients. 41 MDO has been shown to increase not only the length of the mandible ramus and body but also the airway volume in the hypopharynx. 14 Still, there are no large prospective studies of MDO in children with micrognathia.…”

Section: Therapies For Osas In the Paediatric Craniofacial Populationmentioning

confidence: 99%

“…Although no large prospective studies have been performed, available data suggests that tongue-lip adhesion results in a shorter hospital stay but MDO results in improved OSAS and earlier return to oral feeding 43 , at least in non-syndromic infants with micrognathia. Infants undergoing MDO may be less likely to require a second surgery to correct persistent upper airway obstruction 41 .…”

Section: Therapies For Osas In the Paediatric Craniofacial Populationmentioning

confidence: 99%

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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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Section: Therapies For Osas In the Paediatric Craniofacial Populationmentioning

confidence: 99%

Section: Therapies For Osas In the Paediatric Craniofacial Populationmentioning

confidence: 99%

Obstructive sleep apnoea in children with craniofacial syndromes

Cielo

Marcus

2015

Paediatric Respiratory Reviews

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“…Flores et al compared MDO versus TLA (107). They found that patients undergoing MDO demonstrated significantly higher oxygen saturation levels and lower AHI at 1 month and 1 year postoperatively compared with TLA (despite the MDO group showing evidence of more severe airway obstruction pre-procedure).…”

Section: Treatment Of Osa In Children With Pierre Robin Sequencementioning

confidence: 99%

Craniofacial syndromes and sleep-related breathing disorders

Tan

Kheirandish‐Gozal

Abel

et al. 2016

Sleep Medicine Reviews

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Summary Children with craniofacial syndromes are at risk of sleep disordered breathing, the most common being obstructive sleep apnea. Midface hypoplasia in children with craniosynostosis and glossoptosis in children with Pierre Robin syndrome are well recognized risk factors, but the etiology is often multifactorial and many children have multilevel airway obstruction. We examine the published evidence and explore the current management strategies in these complex patients. Some treatment modalities are similar to those used in otherwise healthy children such as as adenotonsillectomy, positive pressure ventilation and in the refractory cases, tracheostomy. However, there are some distinct approaches such as nasopharyngeal airways, tongue lip adhesion, mandibular distraction osteogenesis in children with Pierre Robin sequence, and midface advancement in children with craniosynostoses. Clinicians should have a low threshold for referral for evaluation of sleep-disordered-breathing in these patients.

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“…A meta-analysis found that 84% of children who were tracheostomy dependent were able to be decannulated following MDO [42]. Early studies of MDO in infants reported high rates of clinical resolution of symptoms [42] and subsequent studies involving polysomnography have shown significant improvement in OSA in the majority of patients [43]. There have been no large prospective studies of MDO in children with micrognathia.…”

Section: Management Of Upper Airway Obstructionmentioning

confidence: 99%

“…Recent studies comparing surgical outcomes of TLA with MDO suggest that TLA results in a shorter hospital stay but that MDO is better at treating OSA and earlier return to oral feeding [46], at least in non-syndromic infants with micrognathia. Infants undergoing MDO may be less likely to require a second surgery to correct persistent upper airway obstruction [43]. …”

Section: Management Of Upper Airway Obstructionmentioning

confidence: 99%

Craniofacial disorders associated with airway obstruction in the neonate

Cielo

Montalva

Taylor

2016

Seminars in Fetal and Neonatal Medicine

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SUMMARY In infants with craniofacial disorders, upper airway obstruction is one of the primary causes for morbidity and mortality in the neonatal period. Infants with craniofacial disorders, including Pierre Robin sequence, are at high risk for obstructive sleep apnea syndrome. Because of the complexity of their care, these neonates are usually followed by a multidisciplinary team to ensure timely evaluation and optimal treatment. In addition to history and physical examination, clinical evaluation may include genetic testing, imaging, endoscopy, and polysomnography. There are various treatment options, both surgical and non-surgical, that may be used depending on clinical assessment, underlying condition, and severity of disease. Recent advances have led to better assessment and treatment of these patients, but many questions remain. This review outlines the available literature pertaining to the evaluation and management of upper airway obstruction in the neonate with craniofacial conditions, with a particular focus on Pierre Robin sequence.

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The Surgical Correction of Pierre Robin Sequence

Abstract: Therapeutic, III.

Cited by 115 publications

References 31 publications

Obstructive sleep apnoea in children with craniofacial syndromes

Obstructive sleep apnoea in children with craniofacial syndromes

Craniofacial syndromes and sleep-related breathing disorders

Craniofacial disorders associated with airway obstruction in the neonate

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