To describe the findings of children with Robin Sequence (RS) who received sensory-motor-oral stimulation combined with early sucking during mandibular distraction osteogenesis (MDO), compared with children who did not receive the intervention.
Design
A quasi-experimental study. Setting: A tertiary public hospital. Patients: Children with RS referred to MDO. A historical group from the same population but managed according to the institution's standard protocol (no sucking) served as a control group. Interventions: Sensory-motor-oral stimulation, including sucking, starting 24 h after MDO (intervention group). Main Outcome Measure: Our hypothesis is that sensory-motor-oral stimulation, including sucking during the DOM process, do not negatively affect surgical outcomes.
Results
Twenty-nine children were included. Eight (72.7%) of the 11 patients in the intervention group and 13 (72.2%) of the 18 controls had MDO complications, with no significant difference between the groups (p = 1.000). The most common surgical outcome was antibiotic therapy for surgical site infection (76.2%). Six months after MDO, 22 (75.9%) children attained full oral feeding or associated with alternative feeding methods.
Conclusion
The intervention group did not have higher complication rates, from a surgical point of view, than control group. The protocol adopted by some centers that contraindicates sucking during MDO should be revised to consider the benefits of such stimulation. Keywords: Pierre Robin Syndrome, deglutition, therapeutics, child development.
BreugemCCEvansKNPoetsCF, et al.Best practices for the diagnosis and evaluation of infants with Robin sequence a clinical consensus report. JAMA Pediatr. 2016;170(9):894-902.
2.
CôtéAFanousAAlmajedALacroixY. Pierre Robin sequence: Review of diagnostic and treatment challenges. Int J Pediatr Otorhinolaryngol. 2015;79(4):451-464.
3.
NassarEMarquesILTrindadeASJBettiolH. Feeding-facilitating techniques for the nursing infant with robin sequence. Cleft Palate Craniofac J. 2006;43(1):55-60.
4.
FayouxPDanielSJAllenG, et al.International Pediatric ORL Group (IPOG) Robin Sequence consensus recommendations. Int J Pediatr Otorhinolaryngol. 2020;130:109-855.
5.
WiechersCBuchenauWArandJ, et al.Mandibular growth in infants with Robin sequence treated with the Tübingen palatal plate. Head Face Med. 2019;15(1):17.
6.
WiechersCArandJKoosBPoetsCF. Evidence and practical aspects of treatment with the Tübingen palatal plate. Semin Fetal Neonatal Med. 2021;26(6):101281.
7.
WiechersCThjenTKoosBReinertSPoetsCF. Treatment of infants with craniofacial malformations. Arch Dis Child Fetal Neonatal. 2021;106(1):104-109.
8.
MarquesILPrado-OliveiraRLeiriãoVHVJorgeJCde SouzaL. Clinical and fiberoptic endoscopic evaluation of swallowing in Robin Sequence treated with nasopharyngeal intubation: The importance of feeding facilitating techniques. Cleft Palate Craniofac J. 2010;47(5):523-529.
9.
McNairCYeoMCJohnstonCTaddioA. Nonpharmacologic management of pain during common needle puncture procedures in infants: Current research evidence and practical considerations: An update. Clin Perinatol. 2019;46(4):709-730.
10.
VictoraCGBahlRBarrosAJD, et al.Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-490.
11.
PoetsCFKoosBReinertSWiechersC. The Tübingen palatal plate approach to Robin sequence: Summary of current evidence. J Cranio-Maxillofacial Surg. 2019;47(11):1699-1705.
12.
HarrisJACaprioRMResnickCM. Do infants with Robin Sequence have improved feeding and weight gain after mandibular distraction?J Oral Maxillofac Surg. 2021;79(6):1331-1338.
13.
FucileSGiselELauC. Oral stimulation accelerates the transition from tube to oral feeding in preterm infants. J Pediatr. 2002;141(2):230-236.
14.
PaesECvan NunenDPFBasartH, et al.Birth prevalence of Robin sequence in the Netherlands from 2000-2010: A retrospective population-based study in a large Dutch cohort and review of the literature. Am J Med Genet A. 2015;167(9):1972-1982.
15.
EvansAKRahbarRRogersGFMullikenJBVolkMS. Robin sequence: A retrospective review of 115 patients. Int J Pediatr Otorhinolaryngol. 2006;70(6):973-980.
16.
VatlachSMaasCPoetsCF. Birth prevalence and initial treatment of Robin sequence in Germany: A prospective epidemiologic study. Orphanet J Rare Dis. 2014;9:9.
17.
YellonRF. Epiglottic and base-of-tongue prolapse in children: Grading and management. Laryngoscope. 2006;116(2):194-200.
TsuiWKYangYCheungLKLeungYY. Distraction osteogenesis as a treatment of obstructive sleep apnea syndrome: A systematic review. Medicine (Baltimore). 2016;95(36):e4674.
20.
ZhangRSHoppeICTaylorJABartlettSP. Surgical management and outcomes of Pierre Robin Sequence: A comparison of mandibular distraction osteogenesis and tongue-lip adhesion. Plast Reconstr Surg. 2018;142(2):480-509.
21.
Da CostaALManicaDSchweigerC, et al.The effect of mandibular distraction osteogenesis on airway obstruction and polysomnographic parameters in children with Robin sequence. J Cranio-Maxillofacial Surg. 2018;46(8):1343-1347.
22.
MarquesILSousaTdCarneiroAFPeresSdBBarbieriMABettiolH. Robin sequence: A single treatment protocol. J Pediatr (Rio J). 2005;81(1):14-22.
23.
WiechersCIffländerRGerdesR, et al.Retrospective study on growth in infants with isolated Robin sequence treated with the Tuebingen Palate Plate. Orphanet J Rare Dis. 2021;16(1):338.
24.
Pillai RiddellRRacineNTurcotteK, et al.Nonpharmacological management of procedural pain in infants and young children: An abridged Cochrane review. Pain Res Manag. 2011;16(5):321-330.
25.
MillerCKWillgingJP. The implications of upper-airway obstruction on successful infant feeding. Semin Speech Lang. 2007;28(3):190-203.
26.
MerrowJM. Feeding management in infants with craniofacial anomalies. Facial Plast Surg Clin North Am. 2016;24(4):437-444.
27.
RochaADMoreiraMELPimentaHPRamosJRMLucenaSL. A randomized study of the efficacy of sensory-motor-oral stimulation and non-nutritive sucking in very low birthweight infant. Early Hum Dev. 2007;83(6):385-388.
28.
PimentaHPMoreiraMELRochaADGomesSCPintoLWLucenaSL. Effects of non-nutritive sucking and oral stimulation on breastfeeding rates for preterm, low birth weight infants: A randomized clinical trial. J Pediatr (Rio J). 2008;84(5):423-427.
29.
BacheMPizonEJacobsJVaillantMLecomteA. Effects of pre-feeding oral stimulation on oral feeding in preterm infants: A randomized clinical trial. Early Hum Dev. 2014;90(3):125-129.
30.
Da Rosa PereiraKLevyDSProcianoyRSSilveiraRC. Impact of a pre-feeding oral stimulation program on first feed attempt in preterm infants: Double-blind controlled clinical trial. PLoS One. 2020;15(9):e0237915.
31.
FucileSGiselEGLauC. Effect of an oral stimulation program on sucking skill maturation of preterm infants. Dev Med Child Neurol. 2005;47(3):158-162.
32.
LyuTCZhangYXHuXJCaoYRenPWangYJ. The effect of an early oral stimulation program on oral feeding of preterm infants. Int J Nurs Sci. 2014;1(1):42-47.
33.
MonasterioFOMolinaFBerlangaF, et al.Swallowing disorders in Pierre Robin sequence: Its correction by distraction. J Craniofac Surg. 2004;15(6):934-941.
34.
Van der PlasPPJMStreppelMPullensB, et al.Feeding and swallowing outcomes following mandibular distraction osteogenesis: An analysis of 22 non-isolated paediatric cases. Int J Oral Maxillofac Surg. 2021;21(7):S0901-5027(21)00408-2.
35.
WinnicottDW. Breast-feeding. In: WinnicottDW, ed. The Child, the Family, and the Outside World, 5th edn. Zahar; 1979:56.
36.
WinnicottDW. Breast-feeding as communication. In: WinnicottDW, ed. Babies and their Mothers, 5th edn. Rio de Janeiro; 1988:19-20.
37.
GasparinMSchweigerCManicaD, et al.Accuracy of clinical swallowing evaluation for diagnosis of dysphagia in children with laryngomalacia or glossoptosis. Pediatr Pulmonol. 2017;52(1):41-47.
