title: Validation of the GILLS score for tongue-lip adhesion in Robin sequence patients.
abstract: BACKGROUND
  The GILLS score consists of gastroesophageal reflux disease, preoperative intubation, late surgical intervention, low birth weight, and syndromic diagnosis. The purpose of this study was to test the validity of the GILLS score in predicting success of tongue-lip adhesion (TLA) in managing Robin sequence.
  
  
  METHODS
  Infants with Robin sequence were included in the study if they had a TLA for airway compromise subsequent to formulation of the GILLS scoring system, that is, they were not included in the original GILLS analysis. The patients were prospectively considered based on the presence of the 5 factors that constitute the GILLS score. A score of ≤ 2 predicts success of TLA.
  
  
  RESULTS
  Twenty patients met the inclusion criteria. Tongue-lip adhesion managed the compromised airway in 18 (90%) of 20 patients. Overall, the GILLS score had a sensitivity of 83%, specificity of 50%, positive predictive value of 94%, and negative predictive value of 25%.
  
  
  CONCLUSIONS
  The GILLS score accurately predicts a successful outcome for TLA in infants with Robin sequence. For infants with a score of 2 or less, TLA is the procedure of choice. Infants with a GILLS score of 3 or greater were 5 times more likely to fail TLA than those with a score of 2 or less. In these patients, other methods of managing the airway should be considered.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, Massachusetts 02115, USA. shelly.abramowicz@childrens.harvard.edu
authors.forename: Shelly
authors.initials: S
authors.lastname: Abramowicz
authors.forename: Janine D
authors.initials: JD
authors.lastname: Bacic
authors.forename: John B
authors.initials: JB
authors.lastname: Mulliken
authors.forename: Gary F
authors.initials: GF
authors.lastname: Rogers
mesh_terms: D000402:Airway Obstruction / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008046:Lip / Q000601:surgery*; D008297:Male; D018579:Patient Selection; D010855:Pierre Robin Syndrome / Q000601:surgery*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014059:Tongue / Q000601:surgery*; D016896:Treatment Outcome