The Impact of Mandibular Distraction and Tongue to Lip Adhesion on Feeding in Infants with Isolated Pierre Robin Sequence: A Systematic Review
Creators: name: Thomas, Kendra
name: Sukhu, Rebecca
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2017

description: Purpose or Research Questions: The purpose of this presentation is to investigate the feeding outcomes of mandibular distraction compared to tongue to lip adhesion in infants with Pierre Robin Sequence Background Pierre Robin Sequence (PRS) is a congenital disorder characterized by retroagnathia/micrognathia, glossoptosis, and respiratory distress and may result in a cleft palate. These craniofacial abnormalities cause significant difficulties with feeding and breathing during infancy and childhood. Though surgical intervention is a potential solution for this population, it can only be performed after a certain level of physical development has occurred, often referred to as the Rule of 10s. Children with PRS have difficulty getting the proper nutrition to optimize growth, especially in combination with breathing difficulties, which can result in failure to thrive. It is clinically important to determine the best practices for managing patients affected by craniofacial anomalies and swallowing disorders, including children with PRS who have a complex array of symptoms that impact feeding. Methods/Proposed Methods: The researchers used key terms relating to the disorder and population of choice to search across different databases focused on health science. Next, the researchers completed independent title and abstract reviews in order to exclude unrelated articles. After the title and abstract reviews, researchers performed full text and quality reviews of the remaining studies in order to finalize the data for evaluation. Results/Anticipated Results: The studies being evaluated have employed the use of mandibular distractors and tongue to lip adhesion techniques in order to improve respiration and feeding. In some instances, these interventions were ineffective and tube feeding was necessary to provide sufficient nourishment. A majority of the studies examined were conducted on smaller sample groups, due to the rarity of this condition in the general population. Quality appraisals and data extraction are in the process of being completed. Thus far, we have found that while these interventions provide adequate relief of respiratory distress in order to allow for oral feeding. Further data analysis is currently underway to determine if mandibular distraction or tongue to lip adhesion strategies provide the best outcomes for oral feeding and address feeding difficulties on a holistic level. Discussion (e.g., interpretation of results; potential contribution of anticipated results) Our anticipated results are based on multiple research studies with rather small sample groups. A majority of these studies were conducted using fewer than 50 participants, due to medical complexity of PRS and the relative rarity of studies, which look at patients with isolated PRS not occurring in conjunction with another syndrome and were conducted largely in hospitals with easy access to participants. These small, non-random samples may have skewed research findings in the direction of success for distractors, as they are most commonly used.