scholarly journals The troublesome triumvirate: Temporomandibular joint ankylosis, Pierre Robin syndrome and severe obstructive sleep apnoea

2020 ◽  
Vol 64 (9) ◽  
pp. 800
Author(s):  
Nandini Dave ◽  
Akhil Goel ◽  
Harick Shah ◽  
Priyanka Muneshwar
Keyword(s):  
Temporomandibular Joint ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Pierre Robin Syndrome ◽  
Temporomandibular Joint Ankylosis ◽  
Obstructive Sleep ◽  
Joint Ankylosis ◽  
Pierre Robin

Pierre Robin sequence causes position-dependent obstructive sleep apnoea in infants

2021 ◽  
pp. archdischild-2020-320527
Author(s):  
Hanna-Leena Kristiina Kukkola ◽  
Pia Vuola ◽  
Maija Seppä-Moilanen ◽  
Päivi Salminen ◽  
Turkka Kirjavainen
Keyword(s):  
Eye Movement ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Sleep Position ◽  
Pierre Robin Sequence ◽  
Rapid Eye Movement ◽  
Obstructive Sleep ◽  
Osa Treatment ◽  
Sleep Positioning ◽  
Pierre Robin

IntroductionObstructive sleep apnoea (OSA) and feeding difficulties are key problems for Pierre Robin sequence (PRS) infants. OSA management varies between treatment centres. Sleep positioning represents the traditional OSA treatment, although its effectiveness remains insufficiently evaluated.DesignTo complete a polysomnographic (PSG) evaluation of effect of sleep position on OSA in PRS infants less than 3 months of age. We analysed a 10-year national reference centre dataset of 76 PRS infants. PSG was performed as daytime recordings for 67 in the supine, side and prone sleeping position when possible. In most cases, recording included one cycle of non-rapid eye movement (NREM) and rapid eye movement (REM) sleep in each position.ResultsOne-third of infants (9/76, 12%) had severe OSA needing treatment intervention prior to PSG. During PSG, OSA with an obstructive apnoea and hypopnoea index (OAHI) >5 per hour was noted in 82% (55/67) of infants. OSA was most severe in the supine and mildest in the side or in the prone positions. The median OAHI in the supine, side and prone positions were 31, 16 and 19 per hour of sleep (p=0.003). For 68% (52/67) of the infants, either no treatment or positional treatment alone was considered sufficient.ConclusionsThe incidence of OSA was 84% (64/76) including the nine infants with severe OSA diagnosed prior to PSG. For the most infants, the OSA was sleep position dependent. Our study results support the use of PSG in the evaluation of OSA and the use of sleep positioning as a part of OSA treatment.

scholarly journals A Triad of Temporomandibular Joint Ankylosis, Mandibular Retrognathia and Severe Obstructive Sleep Apnoea: Case report

2018 ◽  
Vol 18 (3) ◽  
pp. 379 ◽  
Author(s):  
Issa K. Al-Nuumani ◽  
Abdulaziz Bakathir ◽  
Ahmed Al-Hashmi ◽  
Mohammed Al-Abri ◽  
Hussein Al-Kindi ◽  
...  
Keyword(s):  
Case Report ◽  
Temporomandibular Joint ◽  
Obstructive Sleep Apnoea ◽  
Mouth Opening ◽  
Sleep Apnoea ◽  
Temporomandibular Joint Disorders ◽  
University Hospital ◽  
Tmj Ankylosis ◽  
Obstructive Sleep ◽  
Mandibular Retrognathia

The surgical management of paediatric patients with temporomandibular joint (TMJ) ankylosis, mandibular retrognathia and obstructive sleep apnoea (OSA) is challenging. We report a nine-year-old boy who presented to the Department of Oral Health, Sultan Qaboos University Hospital, Muscat, Oman, in 2016 with complaints of limited mouth opening, loud snoring and excessive daytime sleepiness. He was diagnosed with TMJ ankylosis, mandibular retrognathia and severe OSA. The patient initially underwent mandibular distraction and, subsequently, release of the TMJ ankylosis and rib graft reconstruction. The overall patient outcome was successful, with improvement in OSA-related symptoms, good facial symmetry and adequate mouth opening.Keywords: Temporomandibular Joint Disorders; Temporomandibular Ankylosis; Retrognathia; Obstructive Sleep Apnea; Case Report; Oman.

Tongue–lip adhesion and tongue repositioning for obstructive sleep apnoea in Pierre Robin sequence: A systematic review and meta-analysis

2017 ◽  
Vol 131 (5) ◽  
pp. 378-383 ◽  
Author(s):  
M Camacho ◽  
M W Noller ◽  
S Zaghi ◽  
L K Reckley ◽  
C Fernandez-Salvador ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Obstructive Sleep Apnoea ◽  
Meta Analysis ◽  
Sleep Apnoea ◽  
Pierre Robin Sequence ◽  
Inclusion Criteria ◽  
Robin Sequence ◽  
Obstructive Sleep ◽  
The Mean ◽  
Pierre Robin

AbstractObjective:To search for studies on tongue–lip adhesion and tongue repositioning used as isolated treatments for obstructive sleep apnoea in children with Pierre Robin sequence.Methods:A systematic literature search of PubMed/Medline and three additional databases, from inception through to 8 July 2016, was performed by two authors.Results:Seven studies with 90 patients (59 tongue–lip adhesion and 31 tongue repositioning patients) met the inclusion criteria. Tongue–lip adhesion reduced the mean (± standard deviation) apnoea/hypopnoea index from 30.8 ± 22.3 to 15.4 ± 18.9 events per hour (50 per cent reduction). The apnoea/hypopnoea index mean difference for tongue–lip adhesion was −15.28 events per hour (95 per cent confidence interval = −30.70 to 0.15;p= 0.05). Tongue–lip adhesion improved the lowest oxygen saturation from 75.8 ± 6.8 to 84.4 ± 7.3 per cent. Tongue repositioning reduced the apnoea/hypopnoea index from 46.5 to 17.4 events per hour (62.6 per cent reduction). Tongue repositioning improved the mean oxygen saturation from 90.8 ± 1.2 to 95.0 ± 0.5 per cent.Conclusion:Tongue–lip adhesion and tongue repositioning can improve apnoea/hypopnoea index and oxygenation parameters in children with Pierre Robin sequence and obstructive sleep apnoea.

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