Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA; Department of Oral and Maxillofacial Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA.
Int J Oral Maxillofac Surg. 2020 Jun;49(6):734-738. doi: 10.1016/j.ijom.2019.10.013. Epub 2019 Nov 6.
The purpose of this study was to evaluate feeding impairment following non-operative or operative management of airway obstruction in a large series of infants with Robin sequence (RS) by rate of G-tube placement. A retrospective study was conducted at Boston Children's Hospital including 225 patients (47.1% female) with RS treated between 1976 and 2018. Subjects were grouped by intervention required for successful management of airway obstruction: non-operative only (n = 120), tongue-lip adhesion (TLA, n = 75), mandibular distraction osteogenesis (MDO, n = 21), or tracheostomy (n = 9). The operative group had a higher rate of G-tube placement (58.1%) than the non-operative group (28.3%, P < 0.0001). Subjects in the TLA and tracheostomy groups had higher odds of G-tube placement than subjects in the MDO group: odds ratio (OR) 5.5 (95% confidence interval (CI) 1.8-17.3, P = 0.004) and OR 27.0 (95% CI 3.2-293.4, P = 0.007), respectively. Syndromic patients and those with gastrointestinal anomalies also had higher odds of G-tube placement: OR 3.5 (95% CI 1.7-7.2, P = 0.001) and OR 5.9 (95% CI 1.6-21.0, P = 0.007), respectively. Infants with RS who require an airway operation and those with a syndromic diagnosis or gastrointestinal anomalies are more likely to require placement of a G-tube. Of the operative groups, MDO was associated with the lowest G-tube rate, compared to TLA and tracheostomy.
本研究的目的是通过胃管放置率评估在罗宾序列（RS）的大量婴儿中，非手术或手术治疗气道阻塞后的喂养障碍。在波士顿儿童医院进行了一项回顾性研究，包括 1976 年至 2018 年间接受治疗的 225 名 RS 患儿（47.1%为女性）。根据气道阻塞成功管理所需的干预措施将受试者分为以下几组：仅非手术治疗（n=120）、舌唇粘连（TLA，n=75）、下颌骨牵引成骨术（MDO，n=21）或气管切开术（n=9）。手术组的胃管放置率（58.1%）高于非手术组（28.3%，P<0.0001）。与 MDO 组相比，TLA 和气管切开术组的患儿放置胃管的可能性更高：比值比（OR）为 5.5（95%置信区间（CI）为 1.8-17.3，P=0.004）和 OR 27.0（95%CI 3.2-293.4，P=0.007）。综合征患儿和胃肠道异常患儿放置胃管的可能性也更高：OR 为 3.5（95%CI 1.7-7.2，P=0.001）和 OR 为 5.9（95%CI 1.6-21.0，P=0.007）。需要气道手术的 RS 患儿以及综合征诊断或胃肠道异常的患儿更有可能需要放置胃管。与 TLA 和气管切开术相比，MDO 手术组的胃管放置率最低。
