title: An oral appliance with velar extension for treatment of obstructive sleep apnea in infants with Pierre Robin sequence.
abstract: OBJECTIVE
  A new oral appliance to treat obstructive sleep apnea in infants with Pierre Robin sequence has recently been shown to be superior to a sham procedure. We now investigate safety and long-term effects of this appliance on obstructive sleep apnea in infants with Pierre Robin sequence.
  
  
  METHODS
  Case series with repetitive follow-up examinations.
  
  
  METHODS
  Tertiary neonatal intensive care unit at the University Children's Hospital Tuebingen, Germany.
  
  
  METHODS
  Fifteen infants (11 girls and four boys; median age, 5 days) with Pierre Robin sequence and obstructive sleep apnea (i.e., mixed-obstructive-apnea index > 3).
  
  
  METHODS
  A custom-made intraoral appliance with velar extension was used continuously in situ from admission until 3 months after hospital discharge.
  
  
  METHODS
  The mixed-obstructive-apnea index was determined prior to the intervention at admission, at discharge, and 3 months later using polygraphic sleep studies. The geometric mean of the mixed-obstructive-apnea index and its 95% confidence interval were calculated.
  
  
  RESULTS
  Compared with admission (mean, 17.2; 95% confidence interval, 11.1-26.7), there was a significant decrease in the mixed-obstructive-apnea index to discharge (mean, 3.8; 95% confidence interval, 2.2-6.6) and 3 months later (mean, 1.2; 95% confidence interval, 0.7-2.2; p value < .001). No severe adverse events occurred.
  
  
  CONCLUSIONS
  This oral appliance was safe and appears to treat obstructive sleep apnea effectively in infants with Pierre Robin sequence.
authors.forename: Margit
authors.initials: M
authors.lastname: Bacher
authors.forename: Judit
authors.initials: J
authors.lastname: Sautermeister
authors.forename: Michael S
authors.initials: MS
authors.lastname: Urschitz
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Buchenau
authors.forename: Joerg
authors.initials: J
authors.lastname: Arand
authors.forename: Christian F
authors.initials: CF
authors.lastname: Poets
mesh_terms: D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D003765:Models, Dental; D009967:Orthodontic Appliances; D010855:Pierre Robin Syndrome / Q000150:complications*; D017286:Polysomnography; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome