We have located links that may give you full text access.
Is Tongue-Lip Adhesion or Mandibular Distraction More Effective in Relieving Obstructive Apnea in Infants With Robin Sequence?
Journal of Oral and Maxillofacial Surgery 2018 September 19
PURPOSE: Tongue-lip adhesion (TLA) and mandibular distraction osteogenesis (MDO) are the most common operations for obstructive apnea (OA) in infants with Robin sequence (RS). The purpose of this study was to compare early outcomes of TLA and MDO on resolution of OA.
MATERIALS AND METHODS: This is a retrospective cohort study of infants with RS treated with TLA or MDO from 2005 through 2018. To be included, patients had to have polysomnograms pre- and postoperatively unless intubated or tracheostomy dependent. Patients were excluded if the operation occurred after 1 year of age. The primary predictor variable was type of operation (TLA or MDO). The primary outcome variable was "successful resolution of OA," defined as 1) postoperative apnea-hypopnea index (AHI) score lower than 5, 2) postoperative OA severity score of 0 to 1 (no to mild OA), and 3) no need for additional airway intervention during the first year of life. Descriptive, bivariate, and regression analyses were performed. Statistical significance was set at a P value less than .05.
RESULTS: Forty-three patients were included (TLA, n = 19 [44%]; MDO, n = 24 [56%]). Eighteen patients (41%) were syndromic. Patients in the TLA group were significantly younger at operation (28.2 ± 23.1 days) compared with those in the MDO group (87.1 ± 81.7 days; P = .002). The MDO group had more severe preoperative OA (AHI score, 20.5 ± 14.9; OA severity score, 4.7 ± 0.8) than the TLA group (AHI score, 17.6 ± 31.0; OA severity score, 3.6 ± 1.4; P < .041). Postoperative AHI score and OA severity score for the TLA group were 11.7 ± 19.5 (33.5% decrease; P = .496) and 2.3 ± 1.8 (improvement by 1.3 ± 2.4 levels; P = .051), respectively. Postoperative AHI score and OA severity score for the MDO group were 1.1 ± 1.8 (94.6% decrease; P < .001) and 0.2 ± 0.4 (improvement by 4.6 ± 0.8 levels; P < .0001), respectively. Successful resolution of OA occurred in 9 patients (47%) in the TLA group and 22 patients (92%) in the MDO group. Postoperative complications were similar.
CONCLUSION: MDO is more effective than TLA in relieving OA in infants with RS.
MATERIALS AND METHODS: This is a retrospective cohort study of infants with RS treated with TLA or MDO from 2005 through 2018. To be included, patients had to have polysomnograms pre- and postoperatively unless intubated or tracheostomy dependent. Patients were excluded if the operation occurred after 1 year of age. The primary predictor variable was type of operation (TLA or MDO). The primary outcome variable was "successful resolution of OA," defined as 1) postoperative apnea-hypopnea index (AHI) score lower than 5, 2) postoperative OA severity score of 0 to 1 (no to mild OA), and 3) no need for additional airway intervention during the first year of life. Descriptive, bivariate, and regression analyses were performed. Statistical significance was set at a P value less than .05.
RESULTS: Forty-three patients were included (TLA, n = 19 [44%]; MDO, n = 24 [56%]). Eighteen patients (41%) were syndromic. Patients in the TLA group were significantly younger at operation (28.2 ± 23.1 days) compared with those in the MDO group (87.1 ± 81.7 days; P = .002). The MDO group had more severe preoperative OA (AHI score, 20.5 ± 14.9; OA severity score, 4.7 ± 0.8) than the TLA group (AHI score, 17.6 ± 31.0; OA severity score, 3.6 ± 1.4; P < .041). Postoperative AHI score and OA severity score for the TLA group were 11.7 ± 19.5 (33.5% decrease; P = .496) and 2.3 ± 1.8 (improvement by 1.3 ± 2.4 levels; P = .051), respectively. Postoperative AHI score and OA severity score for the MDO group were 1.1 ± 1.8 (94.6% decrease; P < .001) and 0.2 ± 0.4 (improvement by 4.6 ± 0.8 levels; P < .0001), respectively. Successful resolution of OA occurred in 9 patients (47%) in the TLA group and 22 patients (92%) in the MDO group. Postoperative complications were similar.
CONCLUSION: MDO is more effective than TLA in relieving OA in infants with RS.
Full text links
Related Resources
Trending Papers
Renin-Angiotensin-Aldosterone System: From History to Practice of a Secular Topic.International Journal of Molecular Sciences 2024 April 5
Albumin: a comprehensive review and practical guideline for clinical use.European Journal of Clinical Pharmacology 2024 April 13
Revascularization Strategy in Myocardial Infarction with Multivessel Disease.Journal of Clinical Medicine 2024 March 27
Clinical practice guidelines on the management of status epilepticus in adults: A systematic review.Epilepsia 2024 April 13
Interstitial Lung Disease: A Review.JAMA 2024 April 23
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app