Cleft Center Amsterdam, Amsterdam UMC, Division of Plastic and Reconstructive Surgery, Location AMC, Meibergdreef.
Cleft Center Amsterdam, Amsterdam UMC, Division of Plastic and Reconstructive Surgery, Location VUmc, Ziekenhuisgebouw, De Boelelaan.
J Craniofac Surg. 2021 Sep 1;32(6):e578-e582. doi: 10.1097/SCS.0000000000007741.
Obstructive respiratory stress and feeding difficulties in infants with Robin sequence (RS) may result in poor weight gain or loss. Following failure of conservative treatment, surgical options include mandibular distraction osteogenesis (MDO) and tongue-lip adhesion (TLA). Whilst both techniques have demonstrated to improve airway patency and feeding behavior, an advantage of either in restoring weight growth remains unknown. This study aimed to improve procedural selection by examining weight gain following MDO and TLA. A retrospective chart review was performed for 17 RS patients that had undergone MDO and 25 that had received TLA. The mean body weight in both groups was below the 50th population percentile at birth and fell further in the period before surgery. A mixed model analysis demonstrated that postoperative weight gain depended on the progression of time and preoperative weight. Conversely, biological sex, congenital comorbidities, method of feeding, the respective cleft team, and the type of surgery did not significantly influence the evolution of postoperative body weight. In conclusion, both MDO and TLA were able to restore weight growth in infants affected by RS, though a clear superiority of either technique could not be established.
患有 Robin 序列征（RS）的婴儿可能会出现呼吸阻塞和喂养困难，从而导致体重增长不良或体重减轻。在保守治疗失败后，手术选择包括下颌骨牵引成骨术（MDO）和舌唇粘连术（TLA）。虽然这两种技术都已被证明可以改善气道通畅性和喂养行为，但哪种技术在恢复体重增长方面具有优势尚不清楚。本研究旨在通过检查 MDO 和 TLA 术后的体重增加来改进手术选择。对 17 例接受 MDO 和 25 例接受 TLA 的 RS 患者进行了回顾性图表审查。两组患者的平均体重在出生时均低于第 50 个百分位数，且在手术前进一步下降。混合模型分析表明，术后体重增加取决于时间的进展和术前体重。相反，性别、先天性合并症、喂养方式、各自的裂隙团队和手术类型对术后体重的变化没有显著影响。总之，MDO 和 TLA 都能够恢复 RS 患儿的体重增长，但不能确定哪种技术具有明显优势。
