Produção Nacional
Revisado por pares
Clinical Experience with Infants with Robin Sequence: A Prospective Study
2001; SAGE Publishing; Volume: 38; Issue: 2 Linguagem: Inglês
10.1597/1545-1569_2001_038_0171_cewiwr_2.0.co_2
ISSN1545-1569
AutoresIlza Lazarini Marques, Telma Vidotto de Sousa, Araken Fernando Carneiro, Marco Antônio Barbieri, Heloísa Bettiol, Manoel Romeu Pereira Gutierrez,
Tópico(s)Tracheal and airway disorders
ResumoObjective To study the clinical course of patients with Robin sequence (RS) during the first 6 months of life. Design A longitudinal prospective study of children with RS. Setting Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru-SP, Brazil, 1997 and 1998. Patients Sixty-two children were studied from hospital admission to 6 months of age. Thirty-three (53.2%) presented with probable isolated RS (PIRS), 25 (40.3%) presented with syndromes or other malformations associated with RS, and 4 (6.5%) presented with RS with neurological involvement. Interventions The type of respiratory tract obstruction was defined by nasopharyngoscopy. The patients with type 1 and type 2 obstruction underwent nasopharyngeal intubation (NPI), and glossopexy was indicated in patients with type 1 obstruction who did not show clinical improvement with this procedure. Tracheostomy was indicated in patients with type 2 obstruction who did not show a good course after NPI, in patients with type 1 obstruction who did not show good course after glossopexy, and in patients with type 3 and type 4 obstruction. Results Prone position treatment (PPT) or NPI was the definitive treatment in 25 cases (75.8%) of PIRS and in 13 cases (52%) of syndromes or other malformations. Among the children with type 1 obstruction, 24 (51.1%) were submitted exclusively to PPT and 12 (25.5%) to NPI. With the type 2 groups, only one (12.5%) received PPT, and three (37.5%) were treated exclusively with NPI. All 15 infants treated exclusively with NPI (24.4%) presented with good weight, length, and neuromotor development. Conclusions Most patients with PIRS and type 1 obstruction improved without surgical intervention. NPI should be the initial treatment in all patients with RS with type 1 and type 2 obstruction who present with important respiratory and feeding difficulties.
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