Gastroesophageal reflux in severe cases of Robin sequence treated with nasopharyngeal intubation.
OBJECTIVE
To study the prevalence of abnormal gastroesophageal reflux in infants with Robin sequence who had severe respiratory obstruction treated with nasopharyngeal intubation and to evaluate the efficacy of nonsurgical treatment.


METHODS
Longitudinal prospective study.


METHODS
Hospital de Reabilitação de Anomalias Craniofaciais, University of São Paulo, Brazil.


METHODS
Twenty infants with severe isolated Robin sequence treated with nasopharyngeal intubation.


METHODS
We performed 24-hour esophageal pH monitoring on each child at 2, 4, and 6 months of age. Respiratory and feeding status were evaluated. We considered abnormal gastroesophageal reflux as reflux index values above the 95th percentile of the Vandenplas reference for normal children.


RESULTS
The prevalence of reflux index above the 95th percentile at the first exam was 6/20, a value significantly higher than the reference (5/103, p < .01). At the second and third exams, reflux index values were decreased. Ninety percent of the infants showed improvement of respiratory difficulty and developed oral feeding capacity.


CONCLUSIONS
The prevalence of abnormal gastroesophageal reflux is higher in infants with severe cases of Robin sequence than in normal infants. Nonsurgical procedures improved respiratory and feeding difficulties of most of these infants.
Marques
Ilza Lazarini
IL
Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, Brazil. marquesi@usp.br
Monteiro
Luiz Carlos Silveira
LC
de Souza
Luiz
L
Bettiol
Heloísa
H
Sassaki
Catarina Hissako
CH
de Assumpção Costa
Renise
R
D001938:Brazil / Q000453:epidemiology; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007441:Intubation, Gastrointestinal / Q000379:methods*; D008137:Longitudinal Studies; D008297:Male; D010855:Pierre Robin Syndrome / Q000150:complications* / Q000628:therapy*; D015995:Prevalence; D011446:Prospective Studies; D018709:Statistics, Nonparametric