Document Type
Article
Publication Date
5-2025
Identifier
DOI: 10.1097/GOX.0000000000006734; PMCID: PMC12047893
Abstract
BACKGROUND: MicroNAPS, a classification for infants with Robin sequence (RS) intended to guide treatment decisions, consists of 5 elements: micrognathia, nutrition, airway, palatal clefting, and syndromes/comorbidities. Scoring of the first 4 elements is well defined, but the assignment of the syndromes/comorbidities score (S score) introduces subjectivity by necessitating judgment regarding the clinical impact of the diagnosis. A database of comorbid diagnoses associated with RS and consensus-based S scores for each is needed for the MicroNAPS system to be reproducible.
METHODS: Diagnoses known to be associated with RS were identified from existing literature, and preliminary severity grades were applied. A series of electronic surveys were distributed to RS experts seeking agreement or recommendation and explanation for updated scoring, according to the Delphi technique, until at least 75% consensus was achieved for each item. A previously published series of 100 infants was rescored according to the resulting grades, and changes from initial scoring were assessed.
RESULTS: A total of 170 associated syndromes and comorbidities were identified. Complete responses were received from 20 of the 35 experts (57.1%) surveyed. Consensus on S scores was achieved for all but 3 diagnoses (98.2%) after 4 rounds of surveys. Rescoring of the published series found 25 (25%) changes in S scores resulting in 5 modifications to R stages.
CONCLUSIONS: We have compiled a comprehensive list of syndromes and comorbid diagnoses associated with RS and achieved expert consensus regarding the impact on early treatment decision-making for most. This list, assigned S scores, and a complete MicroNAPS calculator are publicly available at www.prscalculator.com.
Journal Title
Plast Reconstr Surg Glob Open
Volume
13
Issue
5
First Page
6734
Last Page
6734
PubMed ID
40321327
Recommended Citation
Resnick CM, Heffernan JE, Jindal S, et al. Standardized Classification of Infants With Robin Sequence Using MicroNAPS: The Impact of Syndromes and Comorbidities. Plast Reconstr Surg Glob Open. 2025;13(5):e6734. Published 2025 May 2. doi:10.1097/GOX.0000000000006734
Comments
This article is available under the Creative Commons CC-BY-NC-ND license and permits non-commercial use of the work as published, without adaptation or alteration provided the work is fully attributed.
Publisher's Link: https://journals.lww.com/prsgo/fulltext/2025/05000/standardized_classification_of_infants_with_robin.11.aspx