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Feeding Performance and Outcomes in Infants With Robin Sequence Undergoing Mandibular Distraction Osteogenesis
Heather McGhee1, Daniel Gehle1, Chelsea Shope1
1Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
Summary
Infants with Robin sequence can achieve full oral feeds after mandibular distraction osteogenesis, even with prior feeding difficulties. Syndromic cases have a higher likelihood of needing a G-tube.
Area of Science:
- Pediatric surgery
- Craniofacial anomalies
- Nutritional support
Background:
- Robin sequence (RS) presents significant feeding challenges in infants.
- Mandibular distraction osteogenesis (MDO) is a surgical intervention for RS.
- Perioperative feeding performance is a critical concern for these infants.
Purpose of the Study:
- To evaluate feeding outcomes in infants with RS undergoing MDO.
- To determine the time to full oral feeds post-MDO.
- To assess the need for gastrostomy tube (G-tube) placement and weight changes.
Main Methods:
- Retrospective study of infants with RS who underwent MDO between May 2010 and December 2019.
- Analysis of feeding performance, G-tube rates, and weight percentiles.
- Inclusion criteria applied to a cohort of 20 patients from 40.
Main Results:
- 75% of infants achieved full oral feeds within a mean of 11 days post-MDO, with 80% reaching this milestone within 2 weeks of extubation.
- Infants with syndromic RS had a higher proportion of G-tube placement compared to those with isolated RS.
- Weight percentile decreased in the first 3 months post-MDO, with recovery to preoperative levels by 6 months.
Conclusions:
- Infants with RS can achieve successful oral feeding after MDO, despite preoperative challenges.
- Syndromic RS is a risk factor for requiring a G-tube.
- Findings can guide discussions on G-tube necessity and establish feeding timelines post-MDO.
