Department of Oral and Maxillofacial Surgery, Tuebingen University Hospital, Osianderstrasse 2-8, 72076, Tuebingen, Germany.
Centre for Cleft Palate & Craniofacial Malformations, Tuebingen University Hospital, Tuebingen, Germany.
Clin Oral Investig. 2022 Jul;26(7):4817-4823. doi: 10.1007/s00784-022-04448-3. Epub 2022 Mar 19.
We aimed to determine the neurocognitive development of cleft palate patients with and without Robin sequence (RS).
Children with isolated RS with cleft palate and children with cleft palate only (CPO) were contacted at the age of 5-6 years. All RS children had undergone initial polygraphic sleep study (PG) with a mixed-obstructive apnea index (MOAI) of ≥ 3/h and were consequently treated with the Tuebingen palatal plate. A standardized clinical examination as well as a neuropediatric and neuropsychological examination included the Wechsler Pre-school and Primary Scale of Intelligence (WPPSI-III), Kaufman Assessment Battery for Children (K-ABC), and an assessment of developmental milestones.
In total, 44 children (22RS, 22CPO) were included. RS children were younger at study (70.5 ± 7.3 and 75.2 ± 7.5 months; P = .035). Both groups achieved the evaluated milestones within the normed time frame. WPPSI-III and K-ABC results showed no group differences. Mean values for Verbal IQ (101.8 ± 11.1 vs. 97.1 ± 15.7), Performance IQ (102.9 ± 12.1 vs. 99.6 ± 14.5), Processing Speed Quotient (98.9 ± 15.6 vs. 94.5 ± 15.7), Full-Scale IQ (103.2 ± 12.1 vs. 98.4 ± 15.3), and Sequential Processing Scale (102.1 ± 13.1 vs. 94.2 ± 17.3) were within the reference range (IQ 85-115) for RS and CPO children, respectively, indicating average performance of both groups.
No neurocognitive, physical, or mental impairments were detected suggesting that RS children having upper airway obstruction (UAO) treated early and effectively may use their potential for an age-appropriate neurocognitive development.
Tuebingen palatal plate treatment successfully releases UAO. Thus, isolated RS does not necessarily result in developmental delay or an impaired neurocognitive outcome.
Deutsches Register Klinischer Studien, DRKS00006831, https://www.drks.de/drks_web/.
我们旨在确定有和没有 Robin 序列（RS）的腭裂患者的神经认知发育情况。
5-6 岁时联系患有孤立性 RS 合并腭裂和单纯腭裂（CPO）的儿童。所有患有 RS 的儿童均进行了初始多导睡眠图（PG）检查，混合阻塞性呼吸暂停指数（MOAI）≥3/h，并随后接受了图宾根腭托治疗。标准化的临床检查以及神经儿科学和神经心理学检查包括韦氏学前和小学智力量表（WPPSI-III）、考夫曼儿童评估量表（K-ABC）和发育里程碑评估。
共有 44 名儿童（22 名 RS，22 名 CPO）入组。RS 儿童的研究年龄较小（70.5±7.3 和 75.2±7.5 个月；P=0.035）。两组均在正常时间范围内达到评估的里程碑。WPPSI-III 和 K-ABC 结果显示组间无差异。言语智商平均值（101.8±11.1 与 97.1±15.7）、操作智商平均值（102.9±12.1 与 99.6±14.5）、加工速度商数平均值（98.9±15.6 与 94.5±15.7）、全量表智商平均值（103.2±12.1 与 98.4±15.3）和序列处理量表平均值（102.1±13.1 与 94.2±17.3）均在 RS 和 CPO 儿童的参考范围内（智商 85-115），表明两组的平均表现。
未发现神经认知、身体或精神损伤，表明患有上呼吸道阻塞（UAO）的 RS 儿童经早期有效治疗后，可能会发挥其年龄适当的神经认知发育潜力。
图宾根腭托治疗成功释放 UAO。因此，孤立性 RS 不一定导致发育迟缓或神经认知结果受损。
德国临床试验注册中心，DRKS00006831，https://www.drks.de/drks_web/。
