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Orthodontic plate for management of obstructive sleep apnoea in infants with Pierre Robin sequence: experience and

Angus Ch Ho1, Ricky Wk Wong1, Tania Cheung2

  • 1Department of Dentistry and Maxillofacial Surgery, United Christian Hospital, Hong Kong.

Journal of Orthodontics
|October 11, 2019
PubMed

Insights

The pre-epiglottic baton plate (PEBP) effectively treated obstructive sleep apnea in infants with Pierre Robin sequence (PRS). This approach, combined with respiratory support, led to improved breathing and device weaning within months.

Area of Science:

  • Craniofacial surgery
  • Pediatric sleep medicine
  • Neonatal care

Background:

  • Pierre Robin sequence (PRS) is a congenital condition characterized by micrognathia, glossoptosis, and airway obstruction.
  • Infants with PRS often experience severe obstructive sleep apnea (OSA) due to glossoptosis, requiring effective respiratory support.
  • The pre-epiglottic baton plate (PEBP) is a device used to manage airway obstruction in infants.

Purpose of the Study:

  • To evaluate the application of the pre-epiglottic baton plate (PEBP) in Southern Chinese infants with Pierre Robin sequence (PRS).
  • To outline the diagnosis and management protocol for these infants at the authors' center.
  • To assess the efficacy of PEBP in treating upper airway obstruction and obstructive sleep apnea in infants with PRS.

Main Methods:

  • A retrospective case series of three infants diagnosed with PRS and upper airway obstruction.
  • Initial respiratory support included nasal high-flow oxygen and/or continuous positive airway pressure (CPAP).
  • The pre-epiglottic baton plate (PEBP) was subsequently applied for 3-5 months, utilizing a two-stage approach for accurate positioning.

Main Results:

  • All three infants demonstrated significant improvement in clinical symptoms and polysomnography findings post-treatment.
  • Respiratory aids, including the PEBP, were successfully weaned off between 3 and 6 months of age.
  • The PEBP proved effective in managing obstructive sleep apnea in this cohort of infants with PRS.

Conclusions:

  • The pre-epiglottic baton plate (PEBP), when used with other respiratory support, is a valuable treatment for obstructive sleep apnea in infants with Pierre Robin sequence.
  • The presented diagnosis and management protocol can guide clinical practice for similar cases in the Southern Chinese population.
  • This study supports the use of PEBP as a safe and effective intervention for improving airway patency in infants with PRS.
Abstract

Keywords:
Pierre Robin sequenceairway obstructionorthodontic plate

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