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J Craniomaxillofac Surg. 2016 Dec;44(12):1871-1879. doi: 10.1016/j.jcms.2016.06.021. Epub 2016 Jul 2.

Non-surgical and surgical interventions for airway obstruction in children with Robin Sequence.

Author information

1
Department of Oral and Maxillofacial Surgery, Dutch Craniofacial Center, Erasmus MC, Rotterdam, The Netherlands. Electronic address: m.vanlieshout@erasmusmc.nl.
2
Department of Paediatrics, Dutch Craniofacial Center, Erasmus MC, Rotterdam, The Netherlands. Electronic address: k.joosten@erasmusmc.nl.
3
Department of Plastic, Reconstructive and Hand Surgery, Dutch Craniofacial Center, Erasmus MC, Rotterdam, The Netherlands. Electronic address: i.mathijssen@erasmusmc.nl.
4
Department of Oral and Maxillofacial Surgery, Dutch Craniofacial Center, Erasmus MC, Rotterdam, The Netherlands. Electronic address: m.koudstaal@erasmusmc.nl.
5
Department of Oral and Maxillofacial Surgery, Dutch Craniofacial Center, Erasmus MC, Rotterdam, The Netherlands. Electronic address: e.wolvius@erasmusmc.nl.
6
Department of Otorhinolaryngology-Head and Neck Surgery, Dutch Craniofacial Center, Erasmus MC, Rotterdam, The Netherlands. Electronic address: m.vanderschroeff@erasmusmc.nl.

Abstract

There is widespread lack of consensus regarding treatment of airway obstruction in children with Robin Sequence. This study aimed to systematically summarize outcomes of non-surgical and surgical options to treat airway obstruction in children with Robin Sequence. The authors searched the Medline, EMBASE and CENTRAL databases. Studies primarily on mandibular distraction were excluded. Study quality was appraised with the Methodological Index for Non-Randomized Studies (MINORS) score. Forty-eight studies were included, of which 45 studies had a retrospective non-comparative set up, two studies had a prospective design and one study was a clinical trial. The mean MINORS score was 7.3 (range 3-10). The rates of successful relief of the airway obstruction (SRoAO) were: not available for orthodontic appliance (2 studies, n = 24), 67-100% for nasopharyngeal airway (6 studies, n = 126); 100 % for non-invasive respiratory support (2 studies, n = 12); 70-96% for tongue-lip adhesion (11 studies, n = 277); 50-84% for subperiosteal release of the floor of the mouth (2 studies, n = 47); 100% for mandibular traction (3 studies, n = 133); 100% for tracheostomy (1 study, n = 25). The complication rate ranged from zero to 55%. Although SRoAO rates seemed comparable, high-level evidence remains scarce. Future research should include description of the definition, treatment indication, and objective outcomes.

KEYWORDS:

Airway obstruction; Robin Sequence; Treatment

PMID:
27876376
DOI:
10.1016/j.jcms.2016.06.021
[Indexed for MEDLINE]

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