(1043) Long-Term Outcomes for Conservative Management in Patients With Robin Sequence

Introduction: Robin sequence, the triad of micrognathia, glossoptosis, and airway obstruction is treated with conservative management in milder cases with the expectation that mandibular growth will normalize over time. Mandibular distraction osteogenesis (MDO) is surgical intervention for more severe cases. We aim to identify the long-term outcomes of patients with Robin sequence (RS) who did not undergo neonatal MDO to identify differences in mandibular growth and malocclusion.

Methods: A retrospective review of patients with RS at a tertiary pediatric hospital with complex craniofacial care was conducted from 2002 to 2020. History, physical exam, and apnea studies were reviewed to assess for airway obstruction, dental occlusion, and surgical history.

Results: Of 2,281 records retrieved using CPT codes, 124 RS patients were identified with 92 patients never undergoing neonatal MDO. Of these, 19 patients showed Class I occlusion (36.5%), 27 showed Class II (51.9%), and 6 showed Class III (11.5%). Crossbite occlusion was found in 35 (62.5%). Eight patients either underwent orthognathic surgery at a later date or had consultation for orthognathic surgery (11.4%) while the remainder Class II and III were being observed in the cleft team for future interventions (88.6%).

Conclusions: Our data shows that a significant portion maintained malocclusion into adolescence. This is inconsistent with the self-correction model, leading to lifelong problems with malocclusion or adult orthognathic surgery. Further studies should explore long-term outcomes for Robin Sequence patients who did not undergo MDO as neonates to understand the rate of orthognathic surgery as these patients reach growth maturity.