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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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