Assessment of Health-Related Quality of Life in Robin Sequence: A Comparison of Mandibular Distraction Osteogenesis and Tongue-Lip Adhesion

Robrecht Jh Logjes, Joline F Mermans, Emma C Paes, Marvick Sm Muradin, J Peter Don Griot, Corstiaan C Breugem

Research output: Contribution to journalArticleAcademicpeer-review


Background: Numerous studies have proven the efficacy of mandibular distraction osteogenesis or tongue-lip adhesion in Robin sequence infants with upper airway obstruction. However, none has compared health-related quality of life outcomes. Methods: In the present retrospective study, Robin sequence infants younger than 1 year, who underwent mandibular distraction osteogenesis or tongue-lip adhesion, were included (2006 to 2016). The infants' caregivers were asked to complete a questionnaire based on the Glasgow Children's Benefit Inventory. Results: The response rate was 71 percent (22 of the 31 questionnaires; mandibular distraction osteogenesis, 12 of 15; and tongue-lip adhesion, 10 of 16) and median age at surgery was 24 days (range, 5 to 131 days). Median total Glasgow Children's Benefit Inventory scores after mandibular distraction osteogenesis and after tongue-lip adhesion were 21.9 (interquartile range, 9.4) and 26.0 (interquartile range, 37.5), respectively (p = 0.716), indicating an overall benefit from both procedures. Positive changes were observed in all subgroups emotion, physical health, learning, and vitality. In syndromic Robin sequence, both procedures demonstrated a lower positive change in health-related quality of life compared with isolated Robin sequence (p = 0.303). Conclusions: Both surgical procedures demonstrated an overall benefit in health-related quality-of-life outcomes, with no significant differences. The authors' findings contribute to the debate regarding the use of mandibular distraction osteogenesis versus tongue-lip adhesion in the surgical treatment of Robin sequence; however, studies evaluating health-related quality of life in larger Robin sequence cohorts are necessary to identify which procedure is likely to be best in each individual Robin sequence infant. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Original languageEnglish
Pages (from-to)1456-1465
Number of pages10
JournalPlastic and Reconstructive Surgery
Issue number5
Early online date11 Feb 2019
Publication statusPublished - May 2019


  • Caregivers/statistics & numerical data
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Lip/surgery
  • Male
  • Mandible/abnormalities
  • Osteogenesis, Distraction/methods
  • Pierre Robin Syndrome/surgery
  • Quality of Life
  • Retrospective Studies
  • Surveys and Questionnaires/statistics & numerical data
  • Tissue Adhesions/etiology
  • Tongue/abnormalities
  • Treatment Outcome


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