Clinical trial NCT02432638: Pierre Robin Sequence Outcome Assessment Multi Institutional Study
Official title: Pierre Robin Sequence Outcome Assessment Multi Institutional Study (PROMIS)
Study type: OBSERVATIONAL
Overall status: WITHDRAWN
Conditions: Pierre Robin Sequence
Lead sponsor: NYU Langone Health
Sponsor class: OTHER
Collaborators: name: Indiana University
name: University of Texas
name: University of California, Los Angeles
name: University of Southern California
First posted: 2015-05-04
Enrollment: 0
Sex: ALL
Minimum age (years): 1
Maximum age (years): 6
Standard ages: CHILD
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: This study will include all infants under the age of 6 months who undergo mandibular distraction. We will include all racial and ethnic groups as well as both genders. We will not include patients over the age of 6 months.

Brief summary: The purpose of this prospective, multi-center, longitudinal study is to assess clinical outcomes related to the surgical treatment of PRS ( Pierre Robin Sequence) by MDO (Mandibular distraction osteogenesis). This study aims to develop a scoring system to determine success and complication rate pre and post MDO.

Detailed description: The recruitment phase of this trial is 3 years. Duration of the trial is 19 years.

All study patients who undergo mandibular distraction will be indicated for surgery following published and accepted protocols of care for mandibular distraction in this specific patient population. There will be no experimental/treatment arms in this study. All patients will undergo standard of care interventions and assessments that would not change if the patient were not to participate in this study. The purpose of this study is to follow multiple surgical outcomes following these standard of care practices. The methods and procedures detailed below follow published and accepted standards of care.

Eligibility criteria: Inclusion Criteria:

1. Signed Informed Consent/Assent Form
2. All patients with PRS as defined by mandibular hypoplasia, glossoptosis causing airway obstruction, who undergo MDO prior to the age of 6 months, will be included in the study. This will include all infants regardless of syndromic diagnosis, other organ system abnormalities, cleft palate diagnosis or the presence of other concurrent craniofacial anomalies.

Exclusion Criteria:

1. Infants over the age of 6 months
2. patients who undergo mandibular distraction for conditions other than Pierre Robin sequence.
3. Patient who refuse to be included in this study

Primary outcomes:
measure: Development of Functionality over time
timeFrame: Q 6 years
Secondary outcomes:
measure: Cleft Palate Repair outcome
timeFrame: 1 year
Other outcomes:
measure: mandibular growth
timeFrame: 6 years
measure: Long term outcome
timeFrame: 12 and 18 years
Locations:
city: New York
country: United States
facility: NYU School of Medicine
state: New York
Study officials:
affiliation: NYU School of Medicine
name: Roberto Flores, MD
role: STUDY_CHAIR
References:
citation: Rachmiel A, Emodi O, Rachmiel D, Aizenbud D. Internal mandibular distraction to relieve airway obstruction in children with severe micrognathia. Int J Oral Maxillofac Surg. 2014 Oct;43(10):1176-81. doi: 10.1016/j.ijom.2014.06.013. Epub 2014 Jul 19.
citation: Runyan CM, Uribe-Rivera A, Karlea A, Meinzen-Derr J, Rothchild D, Saal H, Hopkin RJ, Gordon CB. Cost analysis of mandibular distraction versus tracheostomy in neonates with Pierre Robin sequence. Otolaryngol Head Neck Surg. 2014 Nov;151(5):811-8. doi: 10.1177/0194599814542759. Epub 2014 Jul 22.
citation: Cladis F, Kumar A, Grunwaldt L, Otteson T, Ford M, Losee JE. Pierre Robin Sequence: a perioperative review. Anesth Analg. 2014 Aug;119(2):400-412. doi: 10.1213/ANE.0000000000000301.
citation: Scott AR, Mader NS. Regional variations in the presentation and surgical management of Pierre Robin sequence. Laryngoscope. 2014 Dec;124(12):2818-25. doi: 10.1002/lary.24782. Epub 2014 Jun 26.
citation: Denny AD. Discussion: The surgical correction of Pierre Robin sequence: mandibular distraction osteogenesis versus tongue-lip adhesion. Plast Reconstr Surg. 2014 Jun;133(6):1443-1444. doi: 10.1097/PRS.0000000000000182. No abstract available.
citation: Lee JC, Bradley JP. Surgical considerations in pierre robin sequence. Clin Plast Surg. 2014 Apr;41(2):211-7. doi: 10.1016/j.cps.2013.12.007. Epub 2014 Feb 7.
citation: Murage KP, Tholpady SS, Friel M, Havlik RJ, Flores RL. Outcomes analysis of mandibular distraction osteogenesis for the treatment of Pierre Robin sequence. Plast Reconstr Surg. 2013 Aug;132(2):419-421. doi: 10.1097/PRS.0b013e3182958a54.
citation: Tahiri Y, Viezel-Mathieu A, Aldekhayel S, Lee J, Gilardino M. The effectiveness of mandibular distraction in improving airway obstruction in the pediatric population. Plast Reconstr Surg. 2014 Mar;133(3):352e-359e. doi: 10.1097/01.prs.0000438049.29258.a8.
citation: Paes EC, Fouche JJ, Muradin MS, Speleman L, Kon M, Breugem CC. Tracheostomy versus mandibular distraction osteogenesis in infants with Robin sequence: a comparative cost analysis. Br J Oral Maxillofac Surg. 2014 Mar;52(3):223-9. doi: 10.1016/j.bjoms.2013.11.017. Epub 2013 Dec 30.
citation: Balaraman K, Shanmugakrishnan RR, Bharathi RR, Sabapathy SR. Mandibular distraction in a 75-day-old child with severe Pierre Robin sequence. Indian J Plast Surg. 2013 Jan;46(1):154-6. doi: 10.4103/0970-0358.113743. No abstract available.
citation: Lam DJ, Tabangin ME, Shikary TA, Uribe-Rivera A, Meinzen-Derr JK, de Alarcon A, Billmire DA, Gordon CB. Outcomes of mandibular distraction osteogenesis in the treatment of severe micrognathia. JAMA Otolaryngol Head Neck Surg. 2014 Apr;140(4):338-45. doi: 10.1001/jamaoto.2014.16.
citation: Collins B, Powitzky R, Robledo C, Rose C, Glade R. Airway management in pierre robin sequence: patterns of practice. Cleft Palate Craniofac J. 2014 May;51(3):283-9. doi: 10.1597/12-214. Epub 2013 Jul 22.
citation: Schoemann MB, Burstein FD, Bakthavachalam S, Williams JK. Immediate mandibular distraction in mandibular hypoplasia and upper airway obstruction. J Craniofac Surg. 2012 Nov;23(7 Suppl 1):1981-4. doi: 10.1097/SCS.0b013e31825a64d9.
citation: Cicchetti R, Cascone P, Caresta E, Papoff P, Miano S, Cerasaro C, Ramieri V, Midulla F, Moretti C. Mandibular distraction osteogenesis for neonates with Pierre Robin sequence and airway obstruction. J Matern Fetal Neonatal Med. 2012 Oct;25 Suppl 4:141-3. doi: 10.3109/14767058.2012.715011.
citation: Scott AR, Tibesar RJ, Sidman JD. Pierre Robin Sequence: evaluation, management, indications for surgery, and pitfalls. Otolaryngol Clin North Am. 2012 Jun;45(3):695-710, ix. doi: 10.1016/j.otc.2012.03.007.
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