An oral appliance with velar extension for treatment of obstructive sleep apnea in infants with Pierre Robin sequence.
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.
Bacher
Margit
M
Sautermeister
Judit
J
Urschitz
Michael S
MS
Buchenau
Wolfgang
W
Arand
Joerg
J
Poets
Christian F
CF
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