Resnick Cory M, Dentino Kelley, Katz Eliot, Mulliken John B, Padwa Bonnie L
Cleft Palate Craniofac J. 2016 Sep;53(5):584-8. doi: 10.1597/15-058. Epub 2015 Jul 8.
Tongue-lip adhesion (TLA) is commonly used to relieve obstructive sleep apnea (OSA) in infants with Robin sequence (RS), but few studies have evaluated its efficacy with objective measures. The purpose of this study was to measure TLA outcomes using polysomnography. Our hypothesis was that TLA relieves OSA in most infants.
This is a retrospective study of infants with RS who underwent TLA from 2011 to 2014 and had at least a postoperative polysomnogram. Predictor variables included demographic and birth characteristics, surgeon, syndromic diagnosis, GILLS score, preoperative OSA severity, and clinical course. A successful outcome was defined as minimal OSA (apnea-hypopnea index score < 5) on postoperative polysomnogram and no need for additional airway intervention. Descriptive, bivariate, and regression statistics were computed, and statistical significance was set at P < .05.
Eighteen subjects who had TLA at a mean age of 28 ± 4.7 days were included. Thirteen (72.2%) had a confirmed or suspected syndrome, and the mean GILLS score was 3 ± 0.3. All parameters trended toward improvement from the preoperative to postoperative polysomnograms, and improvement in OSA severity, oxygen saturation nadir, and arousals per hour was statistically significant (P < .02). This effect was significant across categories of surgeon, syndrome, and GILLS score. Nine subjects (50%) met the criteria for a successful outcome. Bivariate and regression analyses did not demonstrate a significant relationship between success and any predictor variable.
TLA improved airway obstruction in all infants with RS but resolved OSA in only nine patients, and success was unpredictable.
舌唇粘连术（TLA）常用于缓解患有罗宾序列征（RS）的婴儿的阻塞性睡眠呼吸暂停（OSA），但很少有研究用客观指标评估其疗效。本研究的目的是使用多导睡眠图测量TLA的结果。我们的假设是TLA能缓解大多数婴儿的OSA。
这是一项对2011年至2014年接受TLA且至少有一次术后多导睡眠图的RS婴儿的回顾性研究。预测变量包括人口统计学和出生特征、外科医生、综合征诊断、GILLS评分、术前OSA严重程度和临床过程。成功的结果定义为术后多导睡眠图上的最小OSA（呼吸暂停低通气指数评分<5）且无需额外的气道干预。计算描述性、双变量和回归统计数据，设定统计学显著性为P<.05。
纳入了18名平均年龄为28±4.7天接受TLA的受试者。13名（72.2%）有确诊或疑似综合征，平均GILLS评分为3±0.3。从术前到术后多导睡眠图，所有参数都有改善的趋势，OSA严重程度、最低氧饱和度和每小时觉醒次数的改善具有统计学显著性（P<.02）。这种效果在外科医生、综合征和GILLS评分类别中均显著。9名受试者（50%）符合成功结果的标准。双变量和回归分析未显示成功与任何预测变量之间存在显著关系。
TLA改善了所有RS婴儿的气道阻塞，但仅9例患者的OSA得到缓解，且成功与否不可预测。
