{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:41:19Z","timestamp":1787240479068,"version":"build-2736575974"},"reference-count":30,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>The T\u00fcbingen Palatal Plate (TPP) is a minimally invasive yet highly effective functional orthodontic treatment for upper airway obstruction in infants with Robin Sequence (RS). It consists of a palatal plate to cover the cleft and a velar extension that shifts the root of the tongue forward. We review our practical experience with this approach. First, upon admission, our local orthodontists perform an (3-D) intraoral scan of the maxilla. Based on the scan data, the TPP is manufactured in a semi-digital workflow. The length and angulation of its extension is checked via awake laryngoscopy and the effectiveness confirmed by a sleep study. Plates are kept in place by adhesive cream. When inserting the TPP, the tip of the tongue must be visible. Next, metal fixation bows should be secured to the forehead using tape and elastic bands. Plates are removed daily for cleaning, and the oral mucosa is then checked for pressure marks. Feeding training (initially only via finger feeding) may even start before plate insertion. Breathing often normalizes immediately once the plate is inserted. For isolated RS, we have never had to perform a tracheostomy. This has largely been possible through our highly dedicated and competent team, particularly the nursing staff, and the early involvement of parents.<\/jats:p>","DOI":"10.3390\/children10101628","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T09:39:32Z","timestamp":1695980372000},"page":"1628","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Caring for Infants with Robin Sequence Treated with the T\u00fcbingen Palatal Plate: A Review of Personal Practice"],"prefix":"10.3390","volume":"10","author":[{"given":"Petra","family":"Knechtel","sequence":"first","affiliation":[{"name":"Department of Neonatology, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1771-0650","authenticated-orcid":false,"given":"Christina","family":"Weismann","sequence":"additional","affiliation":[{"name":"Center for Cleft Palate and Craniofacial Malformations, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"},{"name":"Department of Orthodontics, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1072-0066","authenticated-orcid":false,"given":"Christian F.","family":"Poets","sequence":"additional","affiliation":[{"name":"Department of Neonatology, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"},{"name":"Center for Cleft Palate and Craniofacial Malformations, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1097\/00006534-199404001-00006","article-title":"The Pierre Robin sequence: Review of 125 cases andevolution of treatment modalities","volume":"93","author":"Bayet","year":"1994","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1597\/08-061_1","article-title":"Robin Sequence: Clearing Nosologic Confusion","volume":"47","author":"Breugem","year":"2010","journal-title":"Cleft Palate-Craniofacial J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1016\/j.bjps.2008.06.050","article-title":"What is \u2018Pierre Robin sequence\u2019?","volume":"62","author":"Breugem","year":"2009","journal-title":"J. Plast. Reconstr. Aesthet. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1542\/peds.2010-2615","article-title":"Robin Sequence: From Diagnosis to Development of an Effective Management Plan","volume":"127","author":"Evans","year":"2011","journal-title":"Pediatrics"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"109842","DOI":"10.1016\/j.ijporl.2019.109842","article-title":"Associated syndromes in patients with Pierre Robin Sequence","volume":"131","author":"Karempelis","year":"2020","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1136\/archdischild-2023-325556","article-title":"Epidemiology of Robin sequence in the UK and Ireland: An active surveillance study","volume":"108","author":"Wright","year":"2023","journal-title":"Arch. Dis. 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Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.jpeds.2011.07.033","article-title":"Treatment of Upper Airway Obstruction and Feeding Problems in Robin-Like Phenotype","volume":"159","author":"Poets","year":"2011","journal-title":"J. Pediatr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1136\/archdischild-2011-301134","article-title":"The successful use of the nasopharyngeal airway in Pierre Robin sequence: An 11-year experience","volume":"97","author":"Abel","year":"2012","journal-title":"Arch. Dis. Child."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Paradowska-Stolarz, A., Mikulewicz, M., and Du\u015b-Ilnicka, I. (2022). Current Concepts and Challenges in the Treatment of Cleft Lip and Palate Patients\u2014A Comprehensive Review. J. Pers. 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Case Rep."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/10\/1628\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:02:09Z","timestamp":1760130129000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/10\/1628"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,29]]},"references-count":30,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["children10101628"],"URL":"https:\/\/doi.org\/10.3390\/children10101628","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,29]]}}}