Tongue Lip Adhesion in the Treatment of Robin Sequence: Respiratory, Feeding, and Surgical Outcomes

Objective: Objective evaluation of the efficacy of tongue lip adhesion (TLA) in the management of Robin sequence (RS). Study Design: Retrospective cohort study. Setting: Tertiary referral hospital. Patients, Participants: The craniofacial database of Amsterdam UMC, Vrije Universiteit Amsterdam was searched to identify infants with RS who underwent tong lip adhesion (TLA). Forty-one RS infants who underwent TLA from 1993 to 2016 were identified. Interventions: TLA. Main Outcome Measure: The outcome measures were pre- and postoperative polysomnography results, nutritional status, weight gain, age at operation, hospital stay length, extubation time after TLA, and complications. Results: Forty-one RS patients were included who had TLA at an average age of 26.6 days. In 16 cases a pre- and postoperative polysomnography was performed. In 13 of these cases (81.3%) improvement was observed, in 2 (12.5%) the results were inconclusive, and in 1 (6.3%) no improvement was seen. Patients were extubated after a mean of 2.2 days. The mean hospital stay was 40.2 days. Reintervention was needed in 7 patients because of a wound dehiscence. The mean age of TLA release was 9.7 months. At discharge, 9 (22%) children still needed total nutritional support for persistent feeding difficulties. The average growth from birth to adhesion release was 4.6 kg. Conclusion: This cohort demonstrates that TLA is a successful procedure in children with RS in terms of respiratory, feeding, and growth outcome. Only minor complications were seen in our cohort. Address correspondence and reprint requests to Joline F. Mermans, MD, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Plastic-, Reconstructive-, and Handsurgery, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands; E-mail: j.mermans@vumc.nl Received 5 December, 2017 Accepted 23 July, 2018 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

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