Impact of upper airway obstruction management in Robin Sequence on need for myringotomy tubes

Authors

Sam D. Schild, Division of Otolaryngology - Head and Neck Surgery, Yale School of Medicine, New Haven, CT, USA.
Hari N. Magge, The George Washington University School of Medicine and Health Sciences, Washington. D.C, USA.
Hengameh K. Behzadpour, Division of Otolaryngology - Head and Neck Surgery, Children's National Hospital, Washington. D.C, USA.
Esperanza Mantilla-Rivas, Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington. D.C, USA.
Nina M. Afsar, The George Washington University School of Medicine and Health Sciences, Washington. D.C, USA.
Md Sohel Rana, Division of Surgery, Children's National Hospital, Washington. D.C, USA.
Monica Manrique, Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington. D.C, USA.
Albert K. Oh, Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington. D.C, USA.
Brian K. Reilly, Division of Otolaryngology - Head and Neck Surgery, Children's National Hospital, Washington. D.C, USA. Electronic address: breilly@childrensnational.org.

Document Type

Journal Article

Publication Date

5-1-2024

Journal

International journal of pediatric otorhinolaryngology

Volume

180

DOI

10.1016/j.ijporl.2024.111964

Keywords

Cleft palate; Ear disease; Otitis media; Pediatrics; Pierre robin syndrome

Abstract

OBJECTIVE: Investigate an association between upper airway obstruction (UAO) management in Robin Sequence (RS) and need for bilateral myringotomy and tubes (BMT). METHODS: Retrospective chart review of RS patients treated at a tertiary free-standing pediatric hospital from 1995 to 2020 was performed. Patients were grouped based on airway management: conservative, tracheostomy, tongue-lip adhesion (TLA), and mandibular distraction osteogenesis (MDO). Demographic data, cleft palate (CP) association, numbers of BMT and ear infections, and audiogram data including tympanograms were collected. One-way ANOVA and Chi-square/Fisher's exact tests were used to compare continuous and categorical data, respectively. Multivariable regression analysis was used to compare BMT rates between treatment groups. RESULTS: One hundred forty-eight patients were included, 70.3 % of which had CP. Most patients (67.6 %) had at least one BMT; 29.1 % required two or more BMT. The rate of BMT was higher in patients with CP compared to those with intact palates (p = 0.003; 95 % CI 1.30-3.57) and those treated with tracheostomy (p = 0.043; 95 % CI 1.01, 2.27). Surgically managed patients were more likely to have hearing loss (67.5 % vs. 35.3 %, p = 0.017) and ear infections (42.1 % vs. 20.0 %, p = 0.014) pre-compared to post-procedure for airway management. CONCLUSION: Most RS patients require at least 1 set of BMT. Those with CP and/or treated with tracheostomy had a higher likelihood of needing BMT. Rate of hearing loss and ear infection was higher in surgically managed RS patients. Patients with RS and overt CP require a statistically higher number of BMTs compared to those with either submucous cleft palate or intact palate.

APA Citation

Schild, Sam D.; Magge, Hari N.; Behzadpour, Hengameh K.; Mantilla-Rivas, Esperanza; Afsar, Nina M.; Rana, Md Sohel; Manrique, Monica; Oh, Albert K.; and Reilly, Brian K., "Impact of upper airway obstruction management in Robin Sequence on need for myringotomy tubes" (2024). GW Authored Works. Paper 4991.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4991

Department

Pediatrics