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Upper airway changes in Pierre Robin sequence from childhood to adulthood
C B Staudt1, W M Gnoinski, T Peltomäki
1Cleft Lip and Palate Unit, Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
Orthodontics & Craniofacial Research
|January 29, 2013
Summary
Pharyngeal airway dimensions in patients with Pierre Robin sequence (PRS) improve with age, though the oropharyngeal airway shows limited change. Further research is needed to explore obstructive sleep apnea in adults with PRS.
Area of Science:
- Craniofacial development and airway anatomy.
- Longitudinal growth studies in pediatric and adult populations.
- Orthodontic and surgical management of craniofacial anomalies.
Background:
- Pierre Robin sequence (PRS) is a congenital condition characterized by mandibular hypoplasia, glossoptosis, and airway obstruction.
- Pharyngeal airway space is critical for respiration, and its dimensions can be affected by craniofacial morphology.
- Longitudinal data on pharyngeal airway changes in PRS patients from childhood to adulthood are limited.
Purpose of the Study:
- To longitudinally investigate changes in pharyngeal airway dimensions in patients with non-syndromic Pierre Robin sequence (PRS) from childhood to adulthood.
- To assess the influence of adenoid recession, tongue posture, head posture, and mandibular position on airway development.
- To determine if pharyngeal airway dimensions in PRS patients normalize with age.
Main Methods:
- A longitudinal study involving 24 patients with non-syndromic PRS, assessed at ages 5, 10, 15, and 20 years.
- Lateral cephalograms were analyzed to measure pharyngeal airway dimensions, soft palate morphology, tongue and hyoid position, skeletal morphology, and head posture.
- Statistical analysis was performed to identify significant changes and correlations over time.
Main Results:
- Significant increases in nasopharyngeal depth (10.7 to 19.1 mm) and velopharyngeal depth (mainly between ages 15-20) were observed.
- Adenoid recession significantly contributed to nasopharyngeal depth increase, while anterior tongue posture influenced velopharyngeal depth.
- Oropharyngeal depth showed a non-significant increase, associated with head extension and anterior mandibular positioning.
Conclusions:
- Upper airway dimensions, excluding the oropharyngeal area, generally improve with age in PRS patients.
- Despite improvements, mean pharyngeal airway dimensions remain at the lower limit of normal, suggesting potential residual airway issues.
- Further investigation into the prevalence of obstructive sleep apnea in adults with PRS is warranted.
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