The purpose of this study was to evaluate feeding impairment following non-operative or operative management of airway obstruction in a large series of infants with Robin sequence (RS) by rate of G-tube placement. A retrospective study was conducted at Boston Children's Hospital including 225 patients (47.1% female) with RS treated between 1976 and 2018. Subjects were grouped by intervention required for successful management of airway obstruction: non-operative only (n = 120), tongue–lip adhesion (TLA, n = 75), mandibular distraction osteogenesis (MDO, n = 21), or tracheostomy (n = 9). The operative group had a higher rate of G-tube placement (58.1%) than the non-operative group (28.3%, P < 0.0001). Subjects in the TLA and tracheostomy groups had higher odds of G-tube placement than subjects in the MDO group: odds ratio (OR) 5.5 (95% confidence interval (CI) 1.8–17.3, P = 0.004) and OR 27.0 (95% CI 3.2–293.4, P = 0.007), respectively. Syndromic patients and those with gastrointestinal anomalies also had higher odds of G-tube placement: OR 3.5 (95% CI 1.7–7.2, P = 0.001) and OR 5.9 (95% CI 1.6–21.0, P = 0.007), respectively. Infants with RS who require an airway operation and those with a syndromic diagnosis or gastrointestinal anomalies are more likely to require placement of a G-tube. Of the operative groups, MDO was associated with the lowest G-tube rate, compared to TLA and tracheostomy.

Additional Metadata
Keywords airway obstruction, failure-to-thrive, feeding, gastrostomy, mandibular distraction, Robin sequence, tongue–lip adhesion, tracheostomy
Persistent URL dx.doi.org/10.1016/j.ijom.2019.10.013, hdl.handle.net/1765/121912
Journal International Journal of Oral and Maxillofacial Surgery
Citation
El Ghoul, K. (K.), Calabrese, C.E. (C. E.), Koudstaal, M.J, & Resnick, C.M. (C. M.). (2019). A comparison of airway interventions and gastrostomy tube placement in infants with Robin sequence. International Journal of Oral and Maxillofacial Surgery. doi:10.1016/j.ijom.2019.10.013