Abstract：
OBJECTIVE: Investigate an association between upper airway obstruction (UAO) management in Robin Sequence (RS) and need for bilateral myringotomy and tubes (BMT).
METHODS: Retrospective chart review of RS patients treated at a tertiary free-standing pediatric hospital from 1995 to 2020 was performed. Patients were grouped based on airway management: conservative, tracheostomy, tongue-lip adhesion (TLA), and mandibular distraction osteogenesis (MDO). Demographic data, cleft palate (CP) association, numbers of BMT and ear infections, and audiogram data including tympanograms were collected. One-way ANOVA and Chi-square/Fisher\'s exact tests were used to compare continuous and categorical data, respectively. Multivariable regression analysis was used to compare BMT rates between treatment groups.
RESULTS: One hundred forty-eight patients were included, 70.3 % of which had CP. Most patients (67.6 %) had at least one BMT; 29.1 % required two or more BMT. The rate of BMT was higher in patients with CP compared to those with intact palates (p = 0.003; 95 % CI 1.30-3.57) and those treated with tracheostomy (p = 0.043; 95 % CI 1.01, 2.27). Surgically managed patients were more likely to have hearing loss (67.5 % vs. 35.3 %, p = 0.017) and ear infections (42.1 % vs. 20.0 %, p = 0.014) pre-compared to post-procedure for airway management.
CONCLUSIONS: Most RS patients require at least 1 set of BMT. Those with CP and/or treated with tracheostomy had a higher likelihood of needing BMT. Rate of hearing loss and ear infection was higher in surgically managed RS patients. Patients with RS and overt CP require a statistically higher number of BMTs compared to those with either submucous cleft palate or intact palate.
METHODS: Retrospective chart review of RS patients treated at a tertiary free-standing pediatric hospital from 1995 to 2020 was performed. Patients were grouped based on airway management: conservative, tracheostomy, tongue-lip adhesion (TLA), and mandibular distraction osteogenesis (MDO). Demographic data, cleft palate (CP) association, numbers of BMT and ear infections, and audiogram data including tympanograms were collected. One-way ANOVA and Chi-square/Fisher\'s exact tests were used to compare continuous and categorical data, respectively. Multivariable regression analysis was used to compare BMT rates between treatment groups.
RESULTS: One hundred forty-eight patients were included, 70.3 % of which had CP. Most patients (67.6 %) had at least one BMT; 29.1 % required two or more BMT. The rate of BMT was higher in patients with CP compared to those with intact palates (p = 0.003; 95 % CI 1.30-3.57) and those treated with tracheostomy (p = 0.043; 95 % CI 1.01, 2.27). Surgically managed patients were more likely to have hearing loss (67.5 % vs. 35.3 %, p = 0.017) and ear infections (42.1 % vs. 20.0 %, p = 0.014) pre-compared to post-procedure for airway management.
CONCLUSIONS: Most RS patients require at least 1 set of BMT. Those with CP and/or treated with tracheostomy had a higher likelihood of needing BMT. Rate of hearing loss and ear infection was higher in surgically managed RS patients. Patients with RS and overt CP require a statistically higher number of BMTs compared to those with either submucous cleft palate or intact palate.
摘要：
目的：研究RobinSequence（RS）的上呼吸道阻塞（UAO）处理与双侧鼓膜切开术和置管（BMT）之间的关系。
方法：对1995年至2020年在三级独立儿科医院接受治疗的RS患者进行回顾性图表回顾。患者根据气道管理进行分组：保守，气管造口术,舌唇粘连(TLA),下颌骨牵张成骨（MDO）。人口统计数据,腭裂（CP）协会，BMT和耳部感染的数量，收集包括鼓室图在内的听力图数据。单因素方差分析和卡方/Fisher精确检验用于比较连续和分类数据，分别。多变量回归分析用于比较治疗组之间的BMT率。
结果：纳入148名患者，其中70.3%有CP。大多数患者（67.6％）至少有一个BMT；29.1％需要两个或多个BMT。CP患者的BMT发生率高于完整腭的患者（p=0.003；95％CI1.30-3.57）和气管造口术治疗的患者（p=0.043；95％CI1.01，2.27）。手术管理的患者更容易出现听力损失（67.5％vs.35.3%,p=0.017）和耳部感染（42.1%vs.20.0%,p=0.014)与气道管理的术后比较。
结论：大多数RS患者需要至少1组BMT。患有CP和/或接受气管造口术治疗的患者需要BMT的可能性更高。手术管理的RS患者的听力损失和耳部感染率更高。与粘膜下left裂或完整pa的患者相比，RS和明显CP的患者需要统计学上更高的BMT数量。
方法：对1995年至2020年在三级独立儿科医院接受治疗的RS患者进行回顾性图表回顾。患者根据气道管理进行分组：保守，气管造口术,舌唇粘连(TLA),下颌骨牵张成骨（MDO）。人口统计数据,腭裂（CP）协会，BMT和耳部感染的数量，收集包括鼓室图在内的听力图数据。单因素方差分析和卡方/Fisher精确检验用于比较连续和分类数据，分别。多变量回归分析用于比较治疗组之间的BMT率。
结果：纳入148名患者，其中70.3%有CP。大多数患者（67.6％）至少有一个BMT；29.1％需要两个或多个BMT。CP患者的BMT发生率高于完整腭的患者（p=0.003；95％CI1.30-3.57）和气管造口术治疗的患者（p=0.043；95％CI1.01，2.27）。手术管理的患者更容易出现听力损失（67.5％vs.35.3%,p=0.017）和耳部感染（42.1%vs.20.0%,p=0.014)与气道管理的术后比较。
结论：大多数RS患者需要至少1组BMT。患有CP和/或接受气管造口术治疗的患者需要BMT的可能性更高。手术管理的RS患者的听力损失和耳部感染率更高。与粘膜下left裂或完整pa的患者相比，RS和明显CP的患者需要统计学上更高的BMT数量。
