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The Surgical Treatment of Robin Sequence
Shawn Travis Greathouse1, Melinda Costa, Alessandra Ferrera
1From the *Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, IN, †Department of Plastic Surgery, Medical College of Wisconsin, Milwaukee, WI; and ‡Department of Plastic Surgery, NYU Langone Medical Center, New York, NY.
Annals of Plastic Surgery
|September 30, 2015
Summary
Mandibular distraction osteogenesis (MDO) shows better outcomes for Robin sequence patients than tongue-lip adhesion (TLA). MDO resulted in higher success rates and fewer complications, improving airway function significantly.
Area of Science:
- Craniofacial Surgery
- Pediatric Surgery
- Otolaryngology
Background:
- Robin sequence presents significant challenges in infant airway management.
- Surgical interventions like tongue-lip adhesion (TLA) and mandibular distraction osteogenesis (MDO) are used to treat this condition.
- Comorbidities are common in infants with Robin sequence.
Purpose of the Study:
- To compare the surgical outcomes of TLA and MDO in infants with Robin sequence.
- To analyze the incidence of tracheostomy, breathing improvement, and surgical complications.
- To evaluate the long-term effectiveness of these procedures on airway patency.
Main Methods:
- A 19-year retrospective review of syndromic and nonsyndromic neonates with Robin sequence treated with TLA or MDO.
- Data collected included patient demographics, comorbidities, and surgical outcomes.
- Airway improvement was assessed using polysomnography preoperatively and at 1 month and 1 year postoperatively.
Main Results:
- MDO (74 patients) showed a significantly higher success rate (90.5%) compared to TLA (15 patients, 60.0%).
- The MDO group experienced fewer tracheostomies (8.1% vs 33.3%) and surgical complications (20.3% vs 53.3%).
- MDO significantly improved the apnea-hyponea index at 1 month and 1 year post-surgery.
Conclusions:
- Mandibular distraction osteogenesis (MDO) is a more effective surgical treatment for Robin sequence compared to tongue-lip adhesion (TLA).
- MDO offers superior outcomes regarding success rates, complication incidence, and long-term airway improvement.
- These findings support MDO as a preferred intervention for managing complex Robin sequence cases.
