South West Cleft Service, University of Bristol Dental Hospital, Bristol, UK
The Cleft Collective, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK.
Arch Dis Child. 2023 Jan;108(1):42-46. doi: 10.1136/archdischild-2022-324722. Epub 2022 Nov 14.
To determine the prevalence of syndromic Robin sequence (RS) in the UK and if this group of patients had an increased need for airway and feeding management compared with a non-syndromic RS cohort.
A prospective national multicentre study of cases submitted to the Cleft Collective cohort studies.
Specialist cleft services in the UK.
259 participants who fulfilled the diagnosis of RS. This group was compared with 548 participants with cleft palate only (CPO).
The primary outcome measure was the presence of a syndrome in patients with RS and CPO. Secondary outcome measures included the use of airway and feeding adjuncts.
An associated syndrome was seen in 28% of patients with RS and 14% of patients with CPO. The most common syndrome for the RS group was Stickler syndrome (27%). Syndromic status was significantly higher among patients with RS compared with those with CPO (OR 2.36, 95% CI 1.65 to 3.39; p<0.001). Patients with syndromic RS have an increased reliance on airway adjuncts compared with the patients without syndromic RS (OR 2.02, 95% CI 1.13 to 3.64; p=0.018). There was no evidence of a difference in the use of feeding adjuncts between syndromic and non-syndromic RS groups (OR 2.43, 95% CI 0.78 to 7.58; p=0.126).
The presence of a syndrome has implications for management of patients with RS. Early identification of a syndrome may help prevent the consequences of a missed syndromic diagnosis. Routine ophthalmological and genetic screening for Stickler syndrome should be mandatory for all patients with RS.
确定英国综合征性 Robin 序列(RS)的患病率,以及这组患者与非综合征性 RS 队列相比,是否对气道和喂养管理有更高的需求。
一项针对提交给 Cleft Collective 队列研究的病例的全国多中心前瞻性研究。
英国的专业腭裂服务机构。
259 名符合 RS 诊断的患者。将这组患者与 548 名仅患有腭裂(CPO)的患者进行比较。
主要观察指标为 RS 和 CPO 患者中综合征的存在。次要观察指标包括气道和喂养辅助用具的使用。
RS 患者中存在相关综合征的比例为 28%,CPO 患者中为 14%。RS 组最常见的综合征是 Stickler 综合征(27%)。RS 组患者的综合征发生率明显高于 CPO 组(OR 2.36,95%CI 1.65 至 3.39;p<0.001)。与无综合征性 RS 患者相比,患有综合征性 RS 的患者对气道辅助用具的依赖程度更高(OR 2.02,95%CI 1.13 至 3.64;p=0.018)。在综合征性和非综合征性 RS 组之间,使用喂养辅助用具的情况没有差异(OR 2.43,95%CI 0.78 至 7.58;p=0.126)。
综合征的存在对 RS 患者的管理有影响。早期识别综合征可能有助于防止漏诊综合征的后果。所有 RS 患者均应强制性进行常规眼科和 Stickler 综合征的遗传筛查。