{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:36:52Z","timestamp":1777523812478,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T00:00:00Z","timestamp":1648598400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Mandibular distraction osteogenesis (MDO) and continuous positive airway pressure (CPAP) may each have a role in effectively treating tongue-based airway obstruction (TBAO) in Robin sequence (RS). This study describes longitudinal outcomes after treatment of TBAO with CPAP and\/or MDO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Tertiary Pediatric Hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>A total of 129 patients with RS treated with CPAP and\/or MDO from 2009 to 2019 were reviewed. Subjects receiving baseline and at least one follow-up polysomnogram were included. 55 who underwent MDO\u2009\u00b1\u2009CPAP and 9 who received CPAP-only treatment were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>Patient characteristics, feeding, and polysomnographic data were compared and generalized linear mixed modeling performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Baseline obstructive apnea\u2013hypopnea index (OAHI) was greater in the MDO-treated group (median x\u02dc\u2009=\u200933.7 [interquartile range: 26.5-54.5] than the CPAP-treated group (x\u02dc\u2009=\u200920.3[13.3-36.7], P\u2009\u2264\u2009.033). There was significant reduction in OAHI following treatment with CPAP and MDO modalities, P\u2009\u2264\u2009.001. SpO\n                      <jats:sub>2<\/jats:sub>\n                      nadir after MDO was lower in syndromic (x\u02dc\u2009=\u200985.0[81.0-87.9] compared to nonsyndromic patients (x\u02dc\u2009=\u200988.4[86.8-90.5], P\u2009\u2264\u2009.005.) CPAP was utilized following MDO in 2\/24 (8.3%) of nonsyndromic and 16\/31 (51.6%) of syndromic subjects ( P\u2009\u2264\u2009.001,) for a median duration of 414 days. Three patients (5%) underwent tracheostomy, all had MDO. Nasogastric tube feeding at hospital discharge was more common following MDO (44, 80%) than CPAP-only (4, 44.4%, P\u2009\u2264\u2009.036), but did not differ at 6-month follow-up ( P\u2009\u2265\u2009.376).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>CPAP appears to effectively reduce obstructive apnea in patients with RS and moderate TBAO and be a useful adjunct in syndromic patients following MDO with improved but persistent obstruction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656221088173","type":"journal-article","created":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T07:24:22Z","timestamp":1648625062000},"page":"993-1001","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Multimodal Treatment of Robin Sequence Utilizing Mandibular Distraction Osteogenesis and Continuous Positive Airway Pressure"],"prefix":"10.1177","volume":"60","author":[{"given":"Mychajlo S.","family":"Kosyk","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, The Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna R.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, The Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary D.","family":"Zapatero","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, The Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher L.","family":"Kalmar","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, The Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sidra","family":"Liaquat","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, The Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott P.","family":"Bartlett","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, The Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2827-5471","authenticated-orcid":false,"given":"Jesse A.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, The Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher M.","family":"Cielo","sequence":"additional","affiliation":[{"name":"Division of Pulmonary & Sleep Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7112-8114","authenticated-orcid":false,"given":"Jordan W.","family":"Swanson","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, The Children\u2019s Hospital of Philadelphia, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,3,30]]},"reference":[{"key":"bibr1-10556656221088173","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199405000-00032"},{"key":"bibr2-10556656221088173","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.175.6.1751557"},{"key":"bibr3-10556656221088173","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1320065"},{"key":"bibr4-10556656221088173","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3182074799"},{"key":"bibr5-10556656221088173","doi-asserted-by":"publisher","DOI":"10.1597\/10-100"},{"key":"bibr6-10556656221088173","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199307000-00003"},{"key":"bibr7-10556656221088173","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.0796"},{"key":"bibr8-10556656221088173","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2015.10.001"},{"key":"bibr9-10556656221088173","doi-asserted-by":"publisher","DOI":"10.1053\/jpdn.2001.20550"},{"key":"bibr10-10556656221088173","doi-asserted-by":"publisher","DOI":"10.1177\/1055665618774025"},{"key":"bibr11-10556656221088173","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2016.43.6.506"},{"key":"bibr12-10556656221088173","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000475799.07597.23"},{"key":"bibr13-10556656221088173","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-194611000-00007"},{"key":"bibr14-10556656221088173","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000001416"},{"key":"bibr15-10556656221088173","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199289010-00001"},{"key":"bibr16-10556656221088173","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004581"},{"key":"bibr17-10556656221088173","volume-title":"The 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