Customized Pre-Epiglottic Baton Plate-A Practical Guide for Successful, Patient-Specific, Noninvasive Treatment of...

Area of Science:

• Craniofacial surgery
• Pediatric surgery
• Otolaryngology

Background:

• Robin sequence (RS) presents significant challenges in infant airway management.
• The pre-epiglottic baton plate (PEBP) is an effective treatment but not widely adopted.
• Optimizing PEBP indication and design may improve its acceptance.

Purpose of the Study:

• To present a 13-year single-center experience with PEBP for infants with RS.
• To describe an endoscopically guided PEBP design and insertion technique.
• To evaluate the complications and limitations of this PEBP approach.

Main Methods:

• Retrospective review of 132 infants with isolated or syndromic RS treated with PEBP from 2010-2019.
• Description of an endoscopically guided PEBP design with velar extension adjustments.
• Sequential interventions including intravelar veloplasty and hard palate closure.

Main Results:

• PEBP was used as primary treatment in 132 infants (111 isolated RS, 21 syndromic RS).
• Infants with isolated RS were discharged in an average of 8 days, avoiding tracheotomy or tongue-lip adhesion.
• Nasogastric tube dependence was minimal, and subsequent surgical interventions were performed after PEBP treatment.

Conclusions:

• PEBP is a highly effective, non-surgical primary treatment for RS.
• An endoscopically guided approach and tailored design can optimize PEBP outcomes.
• Recommendations are provided to facilitate wider implementation of PEBP for RS treatment.