BEDSIDE POLYSOMNOGRAPHY AS AN ADJUNCT IN THE MANAGEMENT OF INFANTS WITH ROBIN-SEQUENCE

Objective indications for tongue-lip adhesion in infants with Robin se quence have been lacking because of the difficulty in assessing the cl inical significance of airway obstruction. In 1988, we began to use 20 -hour, four-channel polysomnography to assist us in the management of infants with Robin sequence. The four channels included electrocardiog ram, respiratory motion, airflow, and oxygen saturation. Infants demon strating significant episodes of airway obstruction during sleep were recommended for tongue-lip adhesion. Fifteen infants with Robin sequen ce were evaluated during a 3-year period. Two babies were having sever e, clinically obvious events on admission and underwent tongue-lip adh esion without polysomnography. Polysomnography was done on the other 1 3 infants. No significant events were seen in 7 infants, and they were discharged after a mean hospitalization of 8 days. Six studies docume nted significant airway obstruction, and tongue-lip adhesion was recom mended. Follow-up polysomnography performed after successful tongue-li p adhesion failed to show any significant events, and the infants only required hospitalization for a mean of 12 days. We conclude that poly somnography is a useful adjunct in the management of infants with Robi n sequence, providing objective indications for surgical intervention and shortening hospitalization.