{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:29:05Z","timestamp":1787236145692,"version":"build-2736575974"},"reference-count":30,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2016,6,28]]},"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Robin sequence (RS), characterised by micrognathia\/retrognathia and glossoptosis with or without cleft palate, presents with intermittent upper airway obstruction and feeding difficulties. Active intervention is required to reduce the risk of brain damage or sudden death. Most treatment options are poorly studied and\/or invasive. Our group developed a functional approach including early feeding training and the pre-epiglottic baton plate (PEBP), an orthodontic appliance with a velar extension shifting the base of the tongue forward.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>We evaluated the effect of this approach on sleep study results and early weight gain by searching our electronic patient database for infants with isolated RS, born at or referred to our department between 1 January 2003 and 31 December 2012 and treated with the PEBP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 122 patients identified, 360 overnight sleep study results, obtained at admission, prior to hospital discharge and 3\u2005months postdischarge, were available (117 infants had complete data). These showed a decrease in the mixed-obstructive apnoea index from (median; IQR) 8.8 (2.1\u201319.7) to 1.8 (0.6\u20135.4); p&lt;0.001 and 0.2 (0\u20131.3); p&lt;0.001, respectively. Z-scores for weight improved from \u22120.7 (\u22121.39 to \u22120.24) upon admission to \u22120.5 (\u22120.90 to +0.02) at follow-up (p=0.02), accompanied by a decrease in the proportion of infants requiring nasogastric tube feeding from 66% to 8%. No infant required craniofacial surgery or tracheostomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These longitudinal cohort data suggest that this functional approach may be an option to treat both, upper airway obstruction and feeding problems, in infants with isolated RS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/archdischild-2016-311407","type":"journal-article","created":{"date-parts":[[2016,7,19]],"date-time":"2016-07-19T22:43:56Z","timestamp":1468968236000},"page":"F142-F146","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":70,"title":["Functional treatment of airway obstruction and feeding problems in infants with Robin sequence"],"prefix":"10.1136","volume":"102","author":[{"given":"Wolfgang","family":"Buchenau","sequence":"first","affiliation":[{"name":"Department of Neonatology, T\u00fcbingen University Hospital, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Wenzel","sequence":"additional","affiliation":[{"name":"Department of Neonatology, T\u00fcbingen University Hospital, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margit","family":"Bacher","sequence":"additional","affiliation":[{"name":"BIP\u2014Orthodontic Practice, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"M\u00fcller-Hagedorn","sequence":"additional","affiliation":[{"name":"Interdisciplinary Center for Craniofacial Malformations, T\u00fcbingen University Hospital, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joerg","family":"Arand","sequence":"additional","affiliation":[{"name":"Department of Neonatology, T\u00fcbingen University Hospital, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian F","family":"Poets","sequence":"additional","affiliation":[{"name":"Department of Neonatology, T\u00fcbingen University Hospital, T\u00fcbingen, Germany"},{"name":"Interdisciplinary Center for Craniofacial Malformations, T\u00fcbingen University Hospital, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,7,19]]},"reference":[{"key":"2025090510091525000_102.2.F142.1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1934.01960160063005"},{"key":"2025090510091525000_102.2.F142.2","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1542\/peds.36.3.336","article-title":"The Pierre Robin syndrome","volume":"36","author":"Dennison","year":"1965","journal-title":"Pediatrics"},{"key":"2025090510091525000_102.2.F142.3","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569(1992)029<0224:MOAOIR>2.3.CO;2"},{"key":"2025090510091525000_102.2.F142.4","doi-asserted-by":"publisher","DOI":"10.1378\/chest.90.5.711"},{"key":"2025090510091525000_102.2.F142.5","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199404001-00006"},{"key":"2025090510091525000_102.2.F142.6","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(83)90123-6"},{"key":"2025090510091525000_102.2.F142.7","doi-asserted-by":"publisher","DOI":"10.1597\/02-055"},{"key":"2025090510091525000_102.2.F142.8","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2014-306472"},{"key":"2025090510091525000_102.2.F142.9","doi-asserted-by":"publisher","DOI":"10.1136\/adc.42.221.20"},{"key":"2025090510091525000_102.2.F142.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2007.02.063"},{"key":"2025090510091525000_102.2.F142.11","doi-asserted-by":"publisher","DOI":"10.1597\/02-044"},{"key":"2025090510091525000_102.2.F142.12","doi-asserted-by":"crossref","first-page":"30","DOI":"10.52010\/ijom.1993.19.1.6","article-title":"The Castillo-Morales approach to orofacial pathology in Down syndrome","volume":"19","author":"Limbrock","year":"1993","journal-title":"Int J Orofacial Myology"},{"key":"2025090510091525000_102.2.F142.13","doi-asserted-by":"crossref","first-page":"597","DOI":"10.5664\/jcsm.2172","article-title":"Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. 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