Severity of clinical manifestations and laryngeal exposure difficulty predicted by glossoptosis endoscopic grades in Robin sequence patients |
| |
| Affiliation: | 1. Otolaryngology and Head and Neck Surgery Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil;2. Programa de Pós Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil;3. Programa de Pós Graduação em Epidemiologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil;4. Pneumology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil;5. Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil;6. Surgery Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil;7. Pediatric Pneumology Department, Hospital de Clínicas de Porto Alegre, Brazil;1. Tulane University School of Medicine, Department of Otolaryngology/Head and Neck Surgery, New Orleans, LA, USA;2. Ochsner Clinic Foundation, Department of Pediatric Otolaryngology, New Orleans, LA, USA;1. Registrar, Oral and Maxillofacial Surgery Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia; and Masters Candidate, Joanna Briggs Institute, School of Translational Science, University of Adelaide, Adelaide, South Australia, Australia;2. Research Fellow/Supervisor, Joanna Briggs Institute, School of Translational Science, University of Adelaide, Adelaide, South Australia, Australia;3. Supervisor, Joanna Briggs Institute, School of Translational Science, University of Adelaide, Adelaide, South Australia, Australia;4. Professor and Consultant Craniofacial Surgeon, Australian Craniofacial Unit, Women''s and Children''s Hospital, Adelaide, South Australia, Australia;1. University of Pittsburgh School of Medicine, Department of Otolaryngology, 3550 Terrace St, Pittsburgh, PA 15261, United States;2. Department of Otolaryngology, Children''s Hospital of Michigan, 3901 Beaubien St, Detroit, MI 48201, United States;3. Michigan Pediatric Ear, Nose & Throat Associates, 3901 Beaubien St, Detroit, MI 48201, United States;4. Cleft-Craniofacial Center, Children''s Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Pittsburgh, PA, United States;5. Division of Pediatric Otolaryngology, Children''s Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Pittsburgh, PA 15224, United States;1. Service de neurologie, hôtel-Dieu de France, université Saint-Joseph, Achrafieh, Beyrouth, Liban;2. Service de neurochirurgie, Hôtel-Dieu de France, université Saint-Joseph, Achrafieh, Beyrouth, Liban;1. Department of Maxillofacial and Plastic Surgery, Caen University Hospital, 14000, Caen, France;2. UNICAEN, EA7451 Equipe BioConnecT, Avenue de la Côte de Nacre, 14000, Caen, France;3. Medecine Faculty of Caen, University of Caen Basse Normandie, 14032, Caen Cedex 5, France;1. Oral and Maxillofacial Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia;2. Joanna Briggs Institute, School of Translational Science, University of Adelaide, Adelaide, South Australia, Australia;3. Australian Craniofacial Unit, Women''s and Children''s Hospital, Adelaide, South Australia, Australia;4. Oral and Maxillofacial Surgery Unit, Universiti Sains Malaysia, Kota Bharu, Malaysia |
| |
| Abstract: | ObjectiveTo evaluate the performance of two glossoptosis airway obstruction classifications in predicting symptom severity and laryngeal exposure difficulty in Robin Sequence (RS) patients.Setting: Public tertiary hospital otolaryngology section (Hospital de Clínicas de Porto Alegre - HCPA).PatientsAll RS patients diagnosed at HCPA from October 2012 to February 2015 were enrolled, a total of 58 individuals. They were classified in isolated RS, RS-Plus and syndromic RS.InterventionPatients were submitted to sleep endoscopy and a score was attributed according to Yellon and de Sousa by a blinded researcher. Symptom severity evaluation was performed as defined by Cole classification.Main outcome measureAssociation between endoscopic findings and clinical symptoms severity and laryngeal exposure difficulty.ResultsTwenty four patients were identified as isolated RS (41.4%), 19 patients presented as RS-Plus (32.7%) and 15 patients had well defined diagnosed syndromes (25.9%). Concomitant airway anomalies were found in 18 patients (31%). Specifically 17.4% in isolated RS, 55.6% in RS- Plus and 28.6% in the syndromic group had such anomalies (P = 0,03). Probability of presenting severe clinical symptoms as graded by Cole was higher in grade 3 Yellon classification (68.4%, P = 0.012) and in moderate and severe de Sousa classification (61.5% and 62.5%, respectively, P = 0.015) than in milder grades of obstruction. This findings were considered significant even after controlling for patient age. Laryngeal exposure difficulty was correlated with de Sousa and Yellon (Rho = 0,41 and Rho = 0,43, respectively; P < 0,05).ConclusionPatients with higher degrees of obstruction in sleep endoscopy had a higher probability of presenting a more severe clinical manifestation and a more difficult laryngeal exposure. Since the number of patients included in this study was small for subgroup analyses, it is not clear if this association is restricted to a specific group of RS. |
| |
| Keywords: | Endoscopy Intubation Laryngoscopy Mandible Pierre Robin syndrome |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
