Presenter Status
Medical Student
Abstract Type
Clinical Research
Primary Mentor or Principal Investigator
John Dahl, MD, PhD, MBA
Presentation Type
Poster-Restricted Access
Start Date
21-5-2026 12:00 PM
End Date
21-5-2026 1:00 PM
Abstract Text
Background: Robin Sequence (RS) is a congenital anomaly characterized by glossoptosis, micrognathia, and airway obstruction. The goal in treating airway obstruction secondary to RS is to maximize developmental potential; however, identifying the best interventions for individual patients remains a challenge.
Objectives/Goal: We hypothesize that factors derived from clinical evaluations can help identify which RS patients may benefit from invasive vs. conservative treatment. This study attempts to identify such factors.
Methods/Design: With IRB approval, we conducted a single-institution retrospective review of neonates and children with RS. Included participants were treated by our institution between January 1, 2000-July 1, 2025. Analysis and stratification were based on the presence or absence of surgical intervention directed at alleviating airway obstruction. Primary outcomes were clinical history, age of genetic diagnosis, and age of presentation relative to surgery. Polysomnography (PSG) data including obstructive apnea-hypopnea index (oAIH), O2 saturation nadir, and end title CO2 greater than 50% (ETCO2>50%), were also analyzed. Statistical analysis was completed using Fisher’s Exact tests and Mann-Whitney U tests.
Results: A total of 315 patients met inclusion criteria. 164 (54%) subjects underwent surgery, and 151 (46%) subjects had conservative treatment. Factors associated with surgery over conservative treatment were: known or suspected syndrome (p=< 0.001); older age at genetic diagnosis (mean=23.72 months, p=0.017); younger age at presentation to our institution (mean=4.74 months, p=0.021); history of desaturation (p< 0.001); failure to thrive (p< 0.001). A total 112 (68%) of surgery and 83 (59.3%) of conservative treatment patients underwent PSG. On PSG, patients with higher oAHI were more likely to have surgery (mean=27.87, p=0.006). PSG factors that did not associate either surgery or conservative treatment include O2 saturation nadir (p=0.646) and ETCO2>50% (p=0.322).
Conclusions: In the current study, known or suspected syndromes, older age at genetic diagnosis, desaturations, failure to thrive, younger age at presentation, and a higher oAHI were associated with increased likelihood of having an invasive vs. non-invasive treatment for airway obstructions secondary to RS. The data obtained from this analysis will inform multicenter studies aimed at developing risk stratification and diagnostic methods for airway obstruction in RS patients.
Association of Robin Sequence Clinical Characteristics and Polysomnography with Invasive vs Non-Invasive Therapeutic Interventions
Background: Robin Sequence (RS) is a congenital anomaly characterized by glossoptosis, micrognathia, and airway obstruction. The goal in treating airway obstruction secondary to RS is to maximize developmental potential; however, identifying the best interventions for individual patients remains a challenge.
Objectives/Goal: We hypothesize that factors derived from clinical evaluations can help identify which RS patients may benefit from invasive vs. conservative treatment. This study attempts to identify such factors.
Methods/Design: With IRB approval, we conducted a single-institution retrospective review of neonates and children with RS. Included participants were treated by our institution between January 1, 2000-July 1, 2025. Analysis and stratification were based on the presence or absence of surgical intervention directed at alleviating airway obstruction. Primary outcomes were clinical history, age of genetic diagnosis, and age of presentation relative to surgery. Polysomnography (PSG) data including obstructive apnea-hypopnea index (oAIH), O2 saturation nadir, and end title CO2 greater than 50% (ETCO2>50%), were also analyzed. Statistical analysis was completed using Fisher’s Exact tests and Mann-Whitney U tests.
Results: A total of 315 patients met inclusion criteria. 164 (54%) subjects underwent surgery, and 151 (46%) subjects had conservative treatment. Factors associated with surgery over conservative treatment were: known or suspected syndrome (p=< 0.001); older age at genetic diagnosis (mean=23.72 months, p=0.017); younger age at presentation to our institution (mean=4.74 months, p=0.021); history of desaturation (p< 0.001); failure to thrive (p< 0.001). A total 112 (68%) of surgery and 83 (59.3%) of conservative treatment patients underwent PSG. On PSG, patients with higher oAHI were more likely to have surgery (mean=27.87, p=0.006). PSG factors that did not associate either surgery or conservative treatment include O2 saturation nadir (p=0.646) and ETCO2>50% (p=0.322).
Conclusions: In the current study, known or suspected syndromes, older age at genetic diagnosis, desaturations, failure to thrive, younger age at presentation, and a higher oAHI were associated with increased likelihood of having an invasive vs. non-invasive treatment for airway obstructions secondary to RS. The data obtained from this analysis will inform multicenter studies aimed at developing risk stratification and diagnostic methods for airway obstruction in RS patients.
Comments
Poster Board Number: 30