Robin Sequence Facial Profile After Conservative Treatment: A Long-Term Follow-Up.

Area of Science:

• Craniofacial development
• Pediatric plastic surgery
• Orthodontics

Background:

• Robin sequence (RS) is a congenital condition causing micrognathia, glossoptosis, and respiratory distress.
• Conservative treatments address feeding and respiratory issues, but long-term mandibular growth data is limited.
• Understanding craniofacial growth in RS is crucial for predicting long-term outcomes.

Purpose of the Study:

• To assess the longitudinal changes in the facial profile of isolated Robin sequence patients treated conservatively.
• To evaluate craniofacial growth patterns throughout different developmental stages (infant, mixed, and permanent dentition).
• To compare facial profile parameters between RS patients and a control group.

Main Methods:

• Photographic analysis of facial profiles from 100 patients (50 with isolated RS, 50 controls).
• Measurement of facial convexity angle (FCA) at three time points (T1, T2, T3) for RS patients.
• Comparison of FCA, nasolabial angle, mentolabial fold, facial inferior third angle, and facial height ratios between RS and control groups.

Main Results:

• Patients with RS exhibited increased facial convexity, a larger facial inferior third angle, and a higher middle to lower anterior facial height ratio compared to controls.
• Longitudinal analysis revealed that increased facial convexity was most pronounced in infancy and remained relatively stable through mixed and permanent dentition.
• While convexity decreased with growth, retrognathism persisted into permanent dentition in RS patients.

Conclusions:

• Robin sequence is associated with persistent facial convexity and retrognathism, despite some decrease with growth.
• Conservative management of RS does not fully resolve mandibular underdevelopment, often leading to the need for orthognathic surgery.
• Further research into long-term mandibular growth and surgical outcomes in RS is warranted.