Characterizing Differences in Polysomnography Data for Children With Robin Sequence Undergoing Conservative and Surgical Management
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2025
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| author | Angelica M. Walker Thomas Gao Shaun A. Nguyen Allyson V. Drawdy Wendy Estrellado‐Cruz William W. Carroll Phayvanh P. Pecha |
| author_facet | Angelica M. Walker Thomas Gao Shaun A. Nguyen Allyson V. Drawdy Wendy Estrellado‐Cruz William W. Carroll Phayvanh P. Pecha Angelica M. Walker Thomas Gao Shaun A. Nguyen Allyson V. Drawdy Wendy Estrellado‐Cruz William W. Carroll Phayvanh P. Pecha |
| collection | Wiley Open Access |
| contents | Characterizing Differences in Polysomnography Data for Children With Robin Sequence Undergoing Conservative and Surgical Management Angelica M. Walker Thomas Gao Shaun A. Nguyen Allyson V. Drawdy Wendy Estrellado‐Cruz William W. Carroll Phayvanh P. Pecha Otolaryngology–Head and Neck Surgery Abstract Objective To perform a meta‐analysis of polysomnography (PSG) findings in infants with Robin sequence (RS). Data Sources CINAHL, Cochrane Library, PubMed, and Scopus. Review Methods Studies describing PSG results in infants with RS before and/or after intervention were included. Meta‐analysis of mean difference (Δ), proportions (%), and continuous measures with 95% confidence interval (CI) were calculated using random and fixed effects models. Results In total, 45 studies including 1881 infants were analyzed. The mean age at PSG was 24.89 (range 0‐267) days, and 27.92% (CI 21.7‐34.7) had an associated syndrome, with Stickler syndrome being most common (11.08%, CI 9.3‐13.1). At baseline, 79.88% (CI 59.1‐94.5) were diagnosed with severe obstructive sleep apnea. Most patients underwent a mandibular distraction osteogenesis (MDO, 66%), followed by conservative management (14%) or tongue‐lip adhesion (TLA, 11%). Baseline apnea‐hypopnea index (AHI) was highest in the TLA group (39.05/h, CI 8.4‐69.7), compared to the MDO (31.48/h, CI 27.5‐35.5) and conservative treatment groups (19.92/h, CI 15.6‐24.2). There was an improvement in AHI following surgery by 24.52/h (CI 21.4‐27.7) ( P < .001) after MDO and by 25.38/h (CI 1.4‐49.3) ( P = .04) following TLA. Additionally, SpO 2 nadir increased by 11.49% (CI 9.7‐13.3) following MDO. TLA had slightly higher rates of postoperative tracheostomy (5.33%, CI 2.9‐9.4) compared to MDO (3.8%, CI 1.8‐6.5). Conclusion Infants with RS with an AHI approaching 30 tended to undergo surgical intervention. PSG findings improved significantly following MDO and TLA, with few requiring further surgeries including tracheostomy. Future research should explore integrating PSG results with clinical data to inform an algorithm for management. 10.1002/ohn.70039 http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| doi_str_mv | 10.1002/ohn.70039 |
| format | Artículo Open Access |
| id | wiley_oa_10_1002_ohn_70039 |
| institution | Wiley Open Access |
| license_str_mv | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Characterizing Differences in Polysomnography Data for Children With Robin Sequence Undergoing Conservative and Surgical Management Angelica M. Walker Thomas Gao Shaun A. Nguyen Allyson V. Drawdy Wendy Estrellado‐Cruz William W. Carroll Phayvanh P. Pecha Otolaryngology–Head and Neck Surgery Characterizing Differences in Polysomnography Data for Children With Robin Sequence Undergoing Conservative and Surgical Management Angelica M. Walker Thomas Gao Shaun A. Nguyen Allyson V. Drawdy Wendy Estrellado‐Cruz William W. Carroll Phayvanh P. Pecha Otolaryngology–Head and Neck Surgery Abstract Objective To perform a meta‐analysis of polysomnography (PSG) findings in infants with Robin sequence (RS). Data Sources CINAHL, Cochrane Library, PubMed, and Scopus. Review Methods Studies describing PSG results in infants with RS before and/or after intervention were included. Meta‐analysis of mean difference (Δ), proportions (%), and continuous measures with 95% confidence interval (CI) were calculated using random and fixed effects models. Results In total, 45 studies including 1881 infants were analyzed. The mean age at PSG was 24.89 (range 0‐267) days, and 27.92% (CI 21.7‐34.7) had an associated syndrome, with Stickler syndrome being most common (11.08%, CI 9.3‐13.1). At baseline, 79.88% (CI 59.1‐94.5) were diagnosed with severe obstructive sleep apnea. Most patients underwent a mandibular distraction osteogenesis (MDO, 66%), followed by conservative management (14%) or tongue‐lip adhesion (TLA, 11%). Baseline apnea‐hypopnea index (AHI) was highest in the TLA group (39.05/h, CI 8.4‐69.7), compared to the MDO (31.48/h, CI 27.5‐35.5) and conservative treatment groups (19.92/h, CI 15.6‐24.2). There was an improvement in AHI following surgery by 24.52/h (CI 21.4‐27.7) ( P < .001) after MDO and by 25.38/h (CI 1.4‐49.3) ( P = .04) following TLA. Additionally, SpO 2 nadir increased by 11.49% (CI 9.7‐13.3) following MDO. TLA had slightly higher rates of postoperative tracheostomy (5.33%, CI 2.9‐9.4) compared to MDO (3.8%, CI 1.8‐6.5). Conclusion Infants with RS with an AHI approaching 30 tended to undergo surgical intervention. PSG findings improved significantly following MDO and TLA, with few requiring further surgeries including tracheostomy. Future research should explore integrating PSG results with clinical data to inform an algorithm for management. 10.1002/ohn.70039 http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| title | Characterizing Differences in Polysomnography Data for Children With Robin Sequence Undergoing Conservative and Surgical Management |
| topic | Otolaryngology–Head and Neck Surgery |
| url | https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1002/ohn.70039 |