Near-Normalized Maxillomandibular Relationship and Upper Airway in Infants with Robin Sequence Treated with Stanford Orthodontic Airway Plate: Computed Tomography Study.

ObjectiveTo assess craniofacial and upper airway growth in infants with Robin sequence (RS) during the 1st year of life when their severe upper airway obstruction was treated non-surgically with the Stanford orthodontic airway plate treatment program (SOAP).DesignRetrospective longitudinal cohort study comparing SOAP-treated infants with RS (treatment group) with age-matched healthy controls (HC) using computed tomography (CT).SettingSingle tertiary referral hospital.PatientsTwelve SOAP-treated infants with RS.InterventionsSOAP.Main Outcome MeasuresCraniofacial skeletal cephalometric parameters and three-dimensional airway metrics.ResultsNo infants required mandibular distraction or tracheostomy surgery after SOAP. The pre-treatment CT was acquired at the mean age (±SD) of 1.3 months (±0.7). The treatment lasted for 4.8 months (±0.9). Post-treatment CT was acquired at 12.9 months (±2.3) of age. The pre-treatment obstructive apnea hypopnea index decreased from 29.21 events/hour (±14.80) to 4.11 events/hour (±2.21) at post-treatment. The total mandibular length increased from 40.58 mm (±2.98) to 62.15 mm (±2.77) at post-treatment (p < 0.001) resulting in the growth velocity of 51.02% (±11.20) or 20.52 mm (±3.95) per year. The maxillary and mandibular lengths of the treatment group at post-treatment were shorter than those of HC although the maxillomandibular relationship was not different (p = 0.618). The upper airway volume and minimal cross-sectional area were also not different (p = 0.083, p = 0.254, respectively).ConclusionsThe maxillomandibular relationship and upper airway of the SOAP-treated infants with RS were near-normalized at post-treatment, comparable to age-matched healthy infants.