Manica Denise, Schweiger Cláudia, Sekine Leo, Fagondes Simone Chaves, Gasparin Marisa, Levy Deborah Salle, Kuhl Gabriel, Collares Marcus Vinicius, Marostica Paulo José Cauduro
Otolaryngology and Head and Neck Surgery Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Programa de Pós Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Otolaryngology and Head and Neck Surgery Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Programa de Pós Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Int J Pediatr Otorhinolaryngol. 2016 Nov;90:270-275. doi: 10.1016/j.ijporl.2016.09.036. Epub 2016 Sep 28.
To evaluate the performance of two glossoptosis airway obstruction classifications in predicting symptom severity and laryngeal exposure difficulty in Robin Sequence (RS) patients.
Public tertiary hospital otolaryngology section (Hospital de Clínicas de Porto Alegre - HCPA).
All RS patients diagnosed at HCPA from October 2012 to February 2015 were enrolled, a total of 58 individuals. They were classified in isolated RS, RS-Plus and syndromic RS.
Patients were submitted to sleep endoscopy and a score was attributed according to Yellon and de Sousa by a blinded researcher. Symptom severity evaluation was performed as defined by Cole classification.
Association between endoscopic findings and clinical symptoms severity and laryngeal exposure difficulty.
Twenty four patients were identified as isolated RS (41.4%), 19 patients presented as RS-Plus (32.7%) and 15 patients had well defined diagnosed syndromes (25.9%). Concomitant airway anomalies were found in 18 patients (31%). Specifically 17.4% in isolated RS, 55.6% in RS- Plus and 28.6% in the syndromic group had such anomalies (P = 0,03). Probability of presenting severe clinical symptoms as graded by Cole was higher in grade 3 Yellon classification (68.4%, P = 0.012) and in moderate and severe de Sousa classification (61.5% and 62.5%, respectively, P = 0.015) than in milder grades of obstruction. This findings were considered significant even after controlling for patient age. Laryngeal exposure difficulty was correlated with de Sousa and Yellon (Rho = 0,41 and Rho = 0,43, respectively; P < 0,05).
Patients with higher degrees of obstruction in sleep endoscopy had a higher probability of presenting a more severe clinical manifestation and a more difficult laryngeal exposure. Since the number of patients included in this study was small for subgroup analyses, it is not clear if this association is restricted to a specific group of RS.
评估两种舌后坠气道阻塞分类方法在预测罗宾序列征（RS）患者症状严重程度和喉镜暴露困难程度方面的性能。
公立三级医院耳鼻喉科（阿雷格里港临床医院 - HCPA）。
纳入2012年10月至2015年2月在HCPA诊断的所有RS患者，共58例。他们被分为孤立性RS、RS-Plus和综合征性RS。
患者接受睡眠内镜检查，由一名盲法研究人员根据耶伦和德索萨方法进行评分。症状严重程度评估按照科尔分类法进行。
内镜检查结果与临床症状严重程度及喉镜暴露困难程度之间的关联。
24例患者被确定为孤立性RS（41.4%），19例表现为RS-Plus（32.7%），15例有明确诊断的综合征（25.9%）。18例患者（31%）存在合并气道异常。具体而言，孤立性RS中17.4%、RS-Plus中55.6%以及综合征组中28.6%有此类异常（P = 0.03）。根据科尔分级，耶伦分类3级（68.4%，P = 0.012）以及德索萨中度和重度分类（分别为61.5%和62.5%，P = 0.015）出现严重临床症状的概率高于较轻程度的阻塞。即使在控制患者年龄后，这些发现仍被认为具有显著性。喉镜暴露困难程度与德索萨和耶伦分类相关（斯皮尔曼相关系数分别为0.41和0.43；P < 0.05）。
睡眠内镜检查中阻塞程度较高的患者出现更严重临床表现和更困难喉镜暴露的概率更高。由于本研究纳入的患者数量较少，无法进行亚组分析，尚不清楚这种关联是否仅限于特定的RS组。
