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Application of the MicroNAPS Classification for Robin Sequence

Cory M Resnick1,2, Eliot Katz3,4, Alistair Varidel2,5

  • 1Associate Professor of Oral and Maxillofacial Surgery, Harvard Medical School, Boston, MA, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|February 2, 2024
PubMed

Insights

Robin sequence (RS) in infants presents challenges due to varied causes. The novel MicroNAPS classification system offers a standardized approach for diagnosis and management.

Area of Science:

  • Pediatric Medicine
  • Genetics
  • Craniofacial Anomalies

Background:

  • Robin sequence (RS) is characterized by micrognathia, glossoptosis, and upper airway obstruction (UAO), leading to feeding and growth issues.
  • The diverse etiopathogenesis and severity of RS have resulted in inconsistent literature and management strategies.
  • Existing stratification systems for RS have not achieved widespread clinical adoption.

Purpose of the Study:

  • To introduce and validate the MicroNAPS classification system for Robin sequence.
  • To provide a standardized tool for assessing RS severity and guiding clinical decisions.
  • To advocate for the adoption of MicroNAPS in clinical practice and research.

Main Methods:

  • Development of the MicroNAPS classification system, scoring five elements: micrognathia, nutrition, airway, palate, and syndrome/comorbidities.
  • Summarization of element scores into a clinical stage.
  • Testing the system's clinical relevance and predictive value in a cohort of 100 infants with RS.

Main Results:

  • The MicroNAPS system demonstrated clinical relevance in a sample of 100 infants.
  • The classification effectively predicted important management decisions and patient outcomes.
  • The system's utility was confirmed through testing at the authors' center.

Conclusions:

  • The MicroNAPS classification provides a novel, standardized approach to Robin sequence.
  • An interactive website and reference card facilitate the application of MicroNAPS.
  • Widespread adoption of MicroNAPS is recommended for consistent clinical care and research in RS.

Keywords:
Pierre Robin sequencecleft palatedistraction osteogenesisskeletal morphologyupper airway obstruction

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