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Mandibular growth in infants with Robin sequence treated with the Tübingen palatal plate
BACKGROUND: Robin sequence (RS) is characterized by mandibular retrognathia, glossoptosis and upper airway obstruction. Whether mandibular catch-up growth may occur in RS is yet controversial. Our functional and less invasive treatment including the Tübingen Palatal Plate (TPP), early oral feeding a...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6588871/ https://www.ncbi.nlm.nih.gov/pubmed/31228944 http://dx.doi.org/10.1186/s13005-019-0200-1 |
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author | Wiechers, Cornelia Buchenau, Wolfgang Arand, Jörg Oertel, Anne-Friederike Peters, Katharina Müller-Hagedorn, Silvia Koos, Bernd Poets, Christian F. |
author_facet | Wiechers, Cornelia Buchenau, Wolfgang Arand, Jörg Oertel, Anne-Friederike Peters, Katharina Müller-Hagedorn, Silvia Koos, Bernd Poets, Christian F. |
author_sort | Wiechers, Cornelia |
collection | PubMed |
description | BACKGROUND: Robin sequence (RS) is characterized by mandibular retrognathia, glossoptosis and upper airway obstruction. Whether mandibular catch-up growth may occur in RS is yet controversial. Our functional and less invasive treatment including the Tübingen Palatal Plate (TPP), early oral feeding and orofacial stimulation may promote mandibular catch-up growth. We evaluated the effect of the Tübingen Palatal Plate on mandibular growth, expressed by the Jaw index, sleep study results and weight gain in infants admitted with isolated and syndromic RS, born at or referred to our center between 6/2015 and 5/2018. METHODS: Retrospective analysis of our electronic patient database that included data on jaw index measurements, sleep study results and standard deviation (Z-)scores for weight. RESULTS: Of 31 patients referred for RS treatment (22 isolated, 9 syndromic), we had data on the above parameters, determined at admission, discharge and 3 months after discharge, in 20. Jaw index at admission and 3-month follow-up was 8.8 (6.3–11.3) and 2.1 (2.0–4.0), respectively (median (IQR); p < 0.0001). Mixed-obstructive apnea index (MOAI) decreased from 9.7 (4.8–24.2) to 0.0 (0–1.3; p < 0.002). No significant correlation was observed between MOAI and Jaw Index, but MOAI correlated with the Maxillary/Mandibular arch ratio (r = 0.58; p < 0.001). Z-scores for weight were similar at both time points at − 1.34 (− 1.76 – − 0.57) and − 1.50 (− 1.89 – − 0.54), while the proportion of infants requiring nasogastric tube feeding decreased from 84 to 8%. No infant had craniofacial surgery; one with syndromic RS required tracheostomy. CONCLUSION: These longitudinal cohort data suggest that the Tübingen Palatal Plate as used here may alleviate upper airway obstruction by promoting mandibular growth. TRIAL REGISTRATION: N.A. |
format | Online Article Text |
id | pubmed-6588871 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-65888712019-07-08 Mandibular growth in infants with Robin sequence treated with the Tübingen palatal plate Wiechers, Cornelia Buchenau, Wolfgang Arand, Jörg Oertel, Anne-Friederike Peters, Katharina Müller-Hagedorn, Silvia Koos, Bernd Poets, Christian F. Head Face Med Research BACKGROUND: Robin sequence (RS) is characterized by mandibular retrognathia, glossoptosis and upper airway obstruction. Whether mandibular catch-up growth may occur in RS is yet controversial. Our functional and less invasive treatment including the Tübingen Palatal Plate (TPP), early oral feeding and orofacial stimulation may promote mandibular catch-up growth. We evaluated the effect of the Tübingen Palatal Plate on mandibular growth, expressed by the Jaw index, sleep study results and weight gain in infants admitted with isolated and syndromic RS, born at or referred to our center between 6/2015 and 5/2018. METHODS: Retrospective analysis of our electronic patient database that included data on jaw index measurements, sleep study results and standard deviation (Z-)scores for weight. RESULTS: Of 31 patients referred for RS treatment (22 isolated, 9 syndromic), we had data on the above parameters, determined at admission, discharge and 3 months after discharge, in 20. Jaw index at admission and 3-month follow-up was 8.8 (6.3–11.3) and 2.1 (2.0–4.0), respectively (median (IQR); p < 0.0001). Mixed-obstructive apnea index (MOAI) decreased from 9.7 (4.8–24.2) to 0.0 (0–1.3; p < 0.002). No significant correlation was observed between MOAI and Jaw Index, but MOAI correlated with the Maxillary/Mandibular arch ratio (r = 0.58; p < 0.001). Z-scores for weight were similar at both time points at − 1.34 (− 1.76 – − 0.57) and − 1.50 (− 1.89 – − 0.54), while the proportion of infants requiring nasogastric tube feeding decreased from 84 to 8%. No infant had craniofacial surgery; one with syndromic RS required tracheostomy. CONCLUSION: These longitudinal cohort data suggest that the Tübingen Palatal Plate as used here may alleviate upper airway obstruction by promoting mandibular growth. TRIAL REGISTRATION: N.A. BioMed Central 2019-06-22 /pmc/articles/PMC6588871/ /pubmed/31228944 http://dx.doi.org/10.1186/s13005-019-0200-1 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Wiechers, Cornelia Buchenau, Wolfgang Arand, Jörg Oertel, Anne-Friederike Peters, Katharina Müller-Hagedorn, Silvia Koos, Bernd Poets, Christian F. Mandibular growth in infants with Robin sequence treated with the Tübingen palatal plate |
title | Mandibular growth in infants with Robin sequence treated with the Tübingen palatal plate |
title_full | Mandibular growth in infants with Robin sequence treated with the Tübingen palatal plate |
title_fullStr | Mandibular growth in infants with Robin sequence treated with the Tübingen palatal plate |
title_full_unstemmed | Mandibular growth in infants with Robin sequence treated with the Tübingen palatal plate |
title_short | Mandibular growth in infants with Robin sequence treated with the Tübingen palatal plate |
title_sort | mandibular growth in infants with robin sequence treated with the tübingen palatal plate |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6588871/ https://www.ncbi.nlm.nih.gov/pubmed/31228944 http://dx.doi.org/10.1186/s13005-019-0200-1 |
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