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Here’s a summary table for the paper:
Summary Table: Towards Reaching Consensus in the Diagnosis and Management of Infants With Robin Sequence
| Category | Details |
|---|---|
| Authors | Christian F. Poets, Mirja Quante, Cornelia Wiechers |
| Publication Date | 25 March 2025 |
| DOI | 10.1111/apa.70072 |
| Funding | Supported by the European Reference Network on Craniofacial Malformations |
| Background | - Randomized controlled trials (RCTs) are challenging in rare diseases like Pierre Robin Sequence (RS). - Some treatments, such as prone positioning, lack strong evidence despite being widely used. |
| Challenges in RS Management | - Prone positioning can improve symptoms but does not eliminate moderate-to-severe obstructive sleep apnea syndrome (OSAS). - Potential safety concerns, including association with sudden infant death syndrome (SIDS). - Lack of consensus on optimal treatment and diagnostic approaches. |
| Goel et al.’s Approach | - Conducted a three-tiered consensus-building process: reviewing evidence, consulting experts, and incorporating parental perspectives. - Addressed both diagnostic methods and treatment strategies. |
| Diagnostic Concerns | - Disagreement over the accuracy of cardiorespiratory polygraphy (PG) vs. full polysomnography (PSG) for assessing apnea-hypopnea index (AHI). - Questioned the necessity of PSG for all RS infants due to cost, stress, and wait times. |
| Treatment Considerations | - Debate over effects of continuous positive airway pressure (CPAP) and high-flow nasal cannula (HFNC) on facial growth. - Importance of treatments that support proper neuromuscular function and mandibular development. - Tübingen Palatal Plate (TPP) therapy linked to better oral feeding and mandibular catch-up growth. |
| Need for Data-Driven Consensus | - Lack of comparative trials between treatment approaches. - Existing randomized trials are limited in scale and duration. - Standardized outcome measures would improve treatment evaluation. |
| Conclusion | - More prospective data collection and expert consensus on outcome parameters are necessary for evidence-based RS management. |
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Buddha's advice to his son.
"This is because that is.
Myself and others are not separate.
Do not reject one thing only to chase after another.
Practice this and you will become a refreshing source of vitality and happiness for others."
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