Evaluation of the efficacy of tongue-lip adhesion in Pierre Robin sequence

被引:12
作者
Broucqsault, H. [1 ]
Lamblin, M. -D. [2 ]
Hosana, G. [1 ]
Fayoux, P. [1 ]
机构
[1] CHRU Lille, Hop Jeanne de Flandres, Serv ORL Pediat, Ave Eugene Avinee, F-59037 Lille, France
[2] CHRU Lille, Hop Jeanne de Flandres, Serv Neurophysiol clin, Ave Eugene Avinee, F-59037 Lille, France
关键词
Obstructive sleep apnoea; Polysomnography; Pierre Robin sequence; Tongue-lip adhesion; UPPER AIRWAY-OBSTRUCTION; SLEEP-APNEA; ROBIN; PIERRE SEQUENCE; MANAGEMENT; CHILDREN; GLOSSOPEXY; INFANTS; EXPERIENCE;
D O I
10.1016/j.anorl.2017.11.002
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objective: Tongue-lip adhesion may be used to relieve obstructive sleep apnoea in infants with Pierre Robin sequence (PRS), but only a few studies have objectively evaluated its efficacy. The purpose of this study was to evaluate the results of tongue-lip adhesion by polysomnography. Materiel and methods: A single-centre retrospective study was conducted in infants with PRS treated by tongue-lip adhesion from 2004 to 2015, in whom at least laryngotracheal endoscopy and polysomnography were performed. The variables collected were the syndromic diagnosis, demographic data, respiratory management before tongue-lip adhesion, symptoms, and additional airway interventions. Obstructive sleep apnoea was classified into 3 groups according to severity. Polysomnography was performed one month after tongue-lip adhesion. Statistical analysis was performed with Wilcoxon signed-rank test with a limit of statistical significance of P < 0.005. Results: Thirty-seven subjects in whom tongue-lip adhesion was performed at a mean age of 45 days (8 to 210 days) were included. Thirty-one patients had isolated PRS and 6 patients had associated anomalies. All patients had confirmed severe obstructive sleep apnoea. All patients required respiratory support prior to surgery: 8 intubated patients, 15 patients with noninvasive ventilation and 14 patients with nasopharyngeal airways. Eight patients had bradycardia before tongue-lip adhesion. All parameters were improved on postoperative polysomnography: oxygen saturation, hypercapnia, apnoea-hypopnoea index, bradycardia (P < 0.005). Only 8 patients had persistent severe obstructive sleep apnoea and required tracheostomy (n = 5) or noninvasive ventilation (n = 3). No significant correlation was observed between treatment success and any predictive variables. Conclusion: Tongue-lip adhesion improved airway obstruction in all infants with PRS and resolved obstructive sleep apnoea in 29 patients. However, 8 patients required additional airway interventions. (C) 2017 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:155 / 158
页数:4
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