Abstrakt

Results of improving sleep of infants after MDO to treat severe Pierre robin sequence in Vietnam.

Dang Hoang Thom1*, Vu Ngoc Lam, Tran Thiet Son

Pierre Robin Sequence (PRS) refers to a group of birth defects that typically include micrognathia and glossoptosis. These conditions can lead to airway obstruction at the base of the tongue and may be accompanied by cleft palate. Hypoplasia of the mandible leads to glossoptosis, which results in obstruction of the upper airway, feeding difficulties and sleep-disordered breathing. But there are no studies that have reported on the complete range of sleep-related outcomes in infants with Pierre Robin sequence that had undergone Mandibular Distraction Osteogenesis (MDO).

Objective: 73 infants aged 1-12 months with a diagnosis of Pierre Robin Sequence (PRS), who had undergone MDO (MDO) at the Vietnam national children's hospital between 2019 and 2021. Methods: A longitudinal study.

Results: The 73 infants included, 32 (43.8%) were male, 11 (15.1%) were premature and 56 (76.7%) had isolated PRS. The average age at MDO was 35 days (IQR: 22 to 60 days). The infants were extubated on postoperative day 4 (IQR: 3 to 4 days). Tube feeding rate is 89.0%. The mean AHI of the subjects group decreased markedly after MDO treatment; dropped from 25.5 pre-operatively to 1.7 post-operatively (p<0.001). Obstructive Apnea Hypopnea Index (AHI) decreased from 22.1 before MDO to 1.1 after MDO. The lowest SpO2 nadir increased from 74.3% to 84.2%, whereas obstructive apneas reduced from 76.2 to 5.8, hypopneas decreased from 48.1 to 22.1 (p=0.032), and time spent below 90% SpO₂ decreased from 4.3% to 0.7% (p<0.001).

Conclusion: MDO improved several architectural parameters which strongly affect to sleep with PRS.