Nutritional Needs and Growth Patterns in Patients With Robin Sequence Following Mandibular Distraction Osteogenesis.

Area of Science:

• Craniofacial Surgery
• Pediatric Surgery
• Nutritional Support

Background:

• Robin sequence (RS) presents challenges in airway obstruction and oral motor function due to mandibular hypoplasia.
• Nutritional optimization is often delayed in RS patients managing respiratory distress and feeding difficulties.
• Mandibular distraction osteogenesis (MDO) is a key intervention for RS, necessitating evaluation of its impact on nutritional outcomes.

Purpose of the Study:

• To identify predictors of nutritional supplementation in RS patients undergoing MDO.
• To determine the timing of achieving full oral intake post-MDO.
• To assess weight gain patterns in RS patients following MDO.

Main Methods:

• Retrospective review of 94 RS patients who underwent MDO between 2004 and 2022.
• Categorization into syndromic RS (sRS) and isolated RS (iRS) cohorts.
• Analysis of G-tube placement, time to full oral intake, weight-for-length (WFL) percentiles, and average daily weight gain (ADWG).

Main Results:

• 41.5% of patients required G-tube placement; sRS and preterm birth increased odds.
• Full oral intake was achieved at a median of 39 days post-MDO, with sRS patients taking longer (55 days vs. 37 days).
• WFL percentiles initially decreased but improved post-MDO; sRS patients had lower WFL at 12 months, yet comparable ADWG to iRS.

Conclusions:

• MDO improves oral intake and promotes steady weight gain in RS patients.
• Syndromic RS and preterm birth are associated with higher G-tube dependency and delayed oral feeding.
• Tailored nutrition plans and close monitoring are crucial for high-risk RS patients, especially those with syndromic forms.