Catch-Up Growth in Syndromic Robin Sequence: A Systematic Review

Abstract

Objective

The triad of micrognathia, glossoptosis, and airway obstruction defines Robin sequence (RS). Syndromic RS accounts for about 60% of cases, but whether mandibular “catch-up” growth occurs in these cases remains unclear. The aim of the systematic review was to assess the current literature for evidence of catch-up growth in syndromic RS.

Design

A PRISMA-guided systematic literature review was performed. PubMed was searched for studies describing cases with syndromic RS who underwent conservative (non-surgical) management.

Patients, Participants

Case reports, case series, and chart reviews containing both the diagnosis of RS and at least one associated syndrome were included. Review articles, non-English publications, and studies lacking sufficient follow-up or clarity on mandibular morphology were excluded.

Main Outcome Measures

The review assessed micrognathia, mandibular length, catch-up growth, and the necessity of airway enhancement.

Results

Thirty-four studies met the criteria for inclusion. These studies included clinical information from a total of 202 cases and addressed 20 different syndromes. RS in the context of Stickler syndrome and 22q11.2 deletion syndrome were most frequently reported, with multiple studies suggesting potential for balanced maxillo-mandibular growth or apparent catch-up growth. However, definitive conclusions were limited by small study population, heterogeneous methodologies, and variable follow-up durations.

Conclusion

While additional data are needed, available literature suggests that certain syndromic RS groups may exhibit spontaneous mandibular growth, potentially reducing the need for invasive procedures such as distraction osteogenesis. Prospective research employing standardized cephalometric measures is necessary to identify which syndromic subpopulations and RS types benefit from conservative versus surgical management.