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Early changes in airway obstruction in infants with Robin Sequence
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  • Belema Dede,
  • Paul Robinson,
  • Chenda Castro,
  • Karen Waters
Belema Dede
Children's Hospital at Westmead

Corresponding Author:[email protected]

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Paul Robinson
The Children's Hospital at Westmead
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Chenda Castro
The Children`s Hospital at Westmead
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Karen Waters
The Children`s Hospital at Westmead
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Introduction There is limited data available that describe the pattern of change in severity of airway obstruction and treatment requirements of infants with Robin sequence (RS). Methods We undertook retrospective review of 3 infants with RS and severe OSA who were treated with CPAP in early infancy. All were managed at the Children’s Hospital at Westmead. Interval CPAP pressure requirements, sleep screening studies and PSG data were reviewed and obstructive apnoea-hypopnea index (OAHI), oxygen desaturation index (ODI), along with percentage of time <90% oxygen saturation were obtained. Results: For two patients, an early increase in CPAP pressure was observed with peak pressure reached at 5 weeks and 7 weeks, respectively, followed by reduction of pressure requirements and cessation of therapy at age 39 weeks for Patient 1 & 74 weeks for Patient 2. By way of contrast, the clinical course of a 3rd patient included jaw distraction at 17 weeks age, time off CPAP, a requirement to recommence CPAP at 21 weeks, and trials of other therapy, but treatment was eventually ceased at 75 weeks. Apnoea indices on PSG did not reflect the CPAP pressure requirements for any of the infants. Conclusions: Our data suggests a trend toward early increases in CPAP pressure requirements in typical infants with RS, before a decrease and cessation later in infancy. The rate at which this occurs may reflect the underlying severity of obstruction. Further research could help confirm this pattern. KEYWORDS Robin sequence, OSA, CPAP, polysomnography, OAHI, ODI, jaw distraction