The Role of Ankyloglossia as a Protective Factor in Management of Infants With Robin Sequence.

OBJECTIVE

Robin sequence (RS) is an anomaly of micrognathia, glossoptosis, and airway obstruction. This study aims to assess the role of ankyloglossia as a protective factor in infants with RS.

STUDY

DESIGN

Single institution and population-based inpatient registry analysis.

SETTING

Academic medical center.

METHODS

A retrospective 15-year single-institution chart review examined medical records of infants with RS at an urban tertiary care center. Data included patient characteristics, comorbidities/complications, airway interventions, and length of stay (LOS). Conclusions from this smaller sample were compared with analyses from a larger, less detailed, population-based inpatient registry using the Kids' Inpatient Database (2016 and 2019). To quantify associations between patient characteristics and interventions and ankyloglossia, prevalence rates and unadjusted and adjusted odds ratios (ORs) were used.

RESULTS

In the single-institution analysis, five (8.8%) of 57 infants with RS had ankyloglossia. Ankyloglossia was negatively associated with hypoventilation (P = .024), need for airway intervention (P < .001), number of airway interventions (P < .001), and total and NICU LOS (P = .001). In the nationwide analysis, 45 (3.7%) of 1207 weighted hospital births with RS had ankyloglossia. Ankyloglossia was negatively associated with respiratory failure of newborn in both univariate and multivariate analysis (unadjusted OR 0.44, P = .027; adjusted OR 0.19, P = .005), as well as need for mechanical ventilation in univariate analysis (unadjusted OR 0.39, P = .022).

CONCLUSION

In infants with RS, ankyloglossia may be protective against hypoventilation, mechanical ventilation, and the need for airway intervention.