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Neurological Development of Children With Isolated Robin Sequence Treated With Nasopharyngeal Intubation in Early
Insights
Children with isolated Robin sequence (IRS) treated with nasopharyngeal intubation (NPI) showed similar neurodevelopmental outcomes compared to those receiving postural treatment. Exclusive NPI treatment did not result in neurological delays in IRS patients.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Craniofacial Anomalies
Background:
- Isolated Robin sequence (IRS) is a congenital condition affecting craniofacial development.
- The neurodevelopmental impact of different early infancy treatments for IRS requires further investigation.
- Nasopharyngeal intubation (NPI) is used for more severe IRS cases, while postural treatment is for less severe ones.
Purpose of the Study:
- To assess the neurodevelopment of children with IRS.
- To determine if children treated exclusively with NPI exhibit neurological developmental delays.
- To compare neurodevelopmental outcomes between NPI and postural treatment groups.
Main Methods:
- A prospective and cross-sectional study involving 62 children with IRS (38 NPI, 24 postural).
- Children were assessed between 2 to 6 years of age using the Denver II Developmental Screening Test and Neurological Evolutionary Examination (NEE).
- Outcomes were compared between the NPI and postural treatment groups.
Main Results:
- No significant differences in overall neurodevelopment were found between the NPI and postural groups via Denver II (P = .854).
- Normal development was observed in 73.7% (NPI) and 79.2% (postural) by Denver II, and 89.5% (NPI) and 87.5% (postural) by NEE.
- Language development showed a risk for delay in 18.4% (NPI) and 20.8% (postural) of children, potentially linked to speech anatomy and hearing issues (myringotomy rates were 47.4% NPI, 58.3% postural).
Conclusions:
- Isolated Robin sequence treated with NPI demonstrates similar neurological development to less severe cases treated with postural methods.
- Exclusive nasopharyngeal intubation treatment for IRS does not appear to cause neurological developmental delays.
- Language development warrants attention in IRS patients, irrespective of the initial treatment modality.
Abstract:
The study assessed the neurodevelopment of children with isolated Robin sequence (IRS) and evaluated if children treated exclusively with nasopharyngeal intubation (NPI) present delay in neurological development. The prospective and cross-sectional study was conducted at the Hospital for Rehabilitation of Craniofacial Anomalies, Brazil. Children with IRS were divided into two groups according to the type of treatment in early infancy: 38 were treated with NPI (more severe cases) and 24 with postural treatment (less severe cases). Regarding interventions, children were assessed at 2 to 6 years of age using the Denver II Developmental Screening Test (Denver II) and Neurological Evolutionary Examination (NEE). According to Denver II, 73.7% in the NPI group and 79.2% in the postural group presented normal development. This result was similar to the results of different studies in the literature with typical population. Considering all areas of development, there were no significant differences in Denver II between the NPI and postural groups (P = .854). In the NPI group, 89.5% of children and 87.5% in the postural group presented normal development in NEE. Language was the most affected area, as 18.4% and 20.8% of children in NPI and postural group, respectively, presented risk for delay in the Denver II. The increased risk for delay in language area was probably due to anatomical conditions of the muscles involved in speech, and to hearing oscillations, as 47.4% in NPI group and 58.3% in postural group underwent myringotomy. IRS treated with NPI had neurological development similar to those in less severe cases. Children treated exclusively with NPI did not present delay in neurological development.
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