Abstract：
OBJECTIVE: Severe respiratory distress of neonates with Robin sequence (RS) is traditionally managed by surgery. Stanford Orthodontic Airway Plate treatment (SOAP) is a nonsurgical option. The study aimed to determine if SOAP can improve polysomnography (PSG) parameters of neonates with RS.
METHODS: PSG of neonates with RS treated with SOAP at a single hospital were retrospectively analyzed. Patients without PSG at all 4 time points (pre-, start of-, mid-, and post-treatment) were excluded. Data were analyzed using a linear mixed effects model.
RESULTS: Sixteen patients were included. All patients had cleft palate (CP). The median age (min, max) at the start of treatment was 1.1 months (0.5, 2.3) with the treatment duration of 4.5 months (3.5, 6.0). The mean obstructive apnea-hypopnea index (95% confidence interval) decreased from 39.3 events/hour (32.9, 45.7) to 12.2 events/hour (6.7, 17.7) (P < 0.001), obstructive apnea index decreased from 14.1 (11.2, 17.0) events/hour to 1.0 (-1.5, 3.5) events/hour (P < 0.001), and oxygen nadir increased from 79.9% (77.4, 82.5) to 88.2% (85.5, 90.8) (P < 0.001) between pre- and start of treatment. Respiratory improvements were sustained during and after the treatment. All patients avoided mandibular distraction osteogenesis or tracheostomy following SOAP.
CONCLUSIONS: As being a rare diagnosis, the number of participants was, as expected, low. However, the current study demonstrates that SOAP can improve PSG parameters, demonstrating its potential utility before surgical interventions for neonates with RS and CP experiencing severe respiratory distress.
METHODS: PSG of neonates with RS treated with SOAP at a single hospital were retrospectively analyzed. Patients without PSG at all 4 time points (pre-, start of-, mid-, and post-treatment) were excluded. Data were analyzed using a linear mixed effects model.
RESULTS: Sixteen patients were included. All patients had cleft palate (CP). The median age (min, max) at the start of treatment was 1.1 months (0.5, 2.3) with the treatment duration of 4.5 months (3.5, 6.0). The mean obstructive apnea-hypopnea index (95% confidence interval) decreased from 39.3 events/hour (32.9, 45.7) to 12.2 events/hour (6.7, 17.7) (P < 0.001), obstructive apnea index decreased from 14.1 (11.2, 17.0) events/hour to 1.0 (-1.5, 3.5) events/hour (P < 0.001), and oxygen nadir increased from 79.9% (77.4, 82.5) to 88.2% (85.5, 90.8) (P < 0.001) between pre- and start of treatment. Respiratory improvements were sustained during and after the treatment. All patients avoided mandibular distraction osteogenesis or tracheostomy following SOAP.
CONCLUSIONS: As being a rare diagnosis, the number of participants was, as expected, low. However, the current study demonstrates that SOAP can improve PSG parameters, demonstrating its potential utility before surgical interventions for neonates with RS and CP experiencing severe respiratory distress.
摘要：
目的：传统上通过手术治疗具有Robin序列（RS）的新生儿的严重呼吸窘迫。斯坦福正畸气道板治疗（SOAP）是一种非手术选择。该研究旨在确定SOAP是否可以改善RS新生儿的多导睡眠图（PSG）参数。
方法：对单家医院接受SOAP治疗的新生儿的PSG进行回顾性分析。在所有4个时间点没有PSG的患者（前，开始-，mid-,和治疗后）被排除。使用线性混合效应模型分析数据。
结果：纳入16例患者。所有患者均有腭裂（CP）。中位年龄(最小，治疗开始时的max）为1.1个月（0.5，2.3），治疗持续时间为4.5个月（3.5，6.0）。平均阻塞性呼吸暂停低通气指数（95％置信区间）从39.3个事件/小时（32.9，45.7）下降到12.2个事件/小时（6.7，17.7）（P<0.001），阻塞性呼吸暂停指数从14.1(11.2,17.0)个事件/小时下降到1.0(-1.5,3.5)个事件/小时(P<0.001),治疗前和治疗开始之间的氧最低点从79.9％（77.4，82.5）增加到88.2％（85.5，90.8）（P<0.001）。在治疗期间和之后呼吸改善持续。所有患者均避免在SOAP后进行下颌骨牵引成骨或气管造口术。
结论：作为一种罕见的诊断，参与者的数量是，正如预期的那样，低。然而,当前的研究表明，SOAP可以改进PSG参数，在对患有严重呼吸窘迫的RS和CP的新生儿进行手术干预之前，证明了其潜在的实用性。
方法：对单家医院接受SOAP治疗的新生儿的PSG进行回顾性分析。在所有4个时间点没有PSG的患者（前，开始-，mid-,和治疗后）被排除。使用线性混合效应模型分析数据。
结果：纳入16例患者。所有患者均有腭裂（CP）。中位年龄(最小，治疗开始时的max）为1.1个月（0.5，2.3），治疗持续时间为4.5个月（3.5，6.0）。平均阻塞性呼吸暂停低通气指数（95％置信区间）从39.3个事件/小时（32.9，45.7）下降到12.2个事件/小时（6.7，17.7）（P<0.001），阻塞性呼吸暂停指数从14.1(11.2,17.0)个事件/小时下降到1.0(-1.5,3.5)个事件/小时(P<0.001),治疗前和治疗开始之间的氧最低点从79.9％（77.4，82.5）增加到88.2％（85.5，90.8）（P<0.001）。在治疗期间和之后呼吸改善持续。所有患者均避免在SOAP后进行下颌骨牵引成骨或气管造口术。
结论：作为一种罕见的诊断，参与者的数量是，正如预期的那样，低。然而,当前的研究表明，SOAP可以改进PSG参数，在对患有严重呼吸窘迫的RS和CP的新生儿进行手术干预之前，证明了其潜在的实用性。
