Journal article
Standardized Classification of Infants With Robin Sequence Using MicroNAPS: The Impact of Syndromes and Comorbidities
Plastic and reconstructive surgery. Global open, Vol.13(5), e6734
05/02/2025
DOI: 10.1097/GOX.0000000000006734
PMCID: PMC12047893
PMID: 40321327
Abstract
Background:
MicroNAPS, a classification for infants with Robin sequence (RS) intended to guide treatment decisions, consists of 5 elements: micrognathia, nutrition, airway, palatal clefting, and syndromes/comorbidities. Scoring of the first 4 elements is well defined, but the assignment of the syndromes/comorbidities score (S score) introduces subjectivity by necessitating judgment regarding the clinical impact of the diagnosis. A database of comorbid diagnoses associated with RS and consensus-based S scores for each is needed for the MicroNAPS system to be reproducible.
Methods:
Diagnoses known to be associated with RS were identified from existing literature, and preliminary severity grades were applied. A series of electronic surveys were distributed to RS experts seeking agreement or recommendation and explanation for updated scoring, according to the Delphi technique, until at least 75% consensus was achieved for each item. A previously published series of 100 infants was rescored according to the resulting grades, and changes from initial scoring were assessed.
Results:
A total of 170 associated syndromes and comorbidities were identified. Complete responses were received from 20 of the 35 experts (57.1%) surveyed. Consensus on S scores was achieved for all but 3 diagnoses (98.2%) after 4 rounds of surveys. Rescoring of the published series found 25 (25%) changes in S scores resulting in 5 modifications to R stages.
Conclusions:
We have compiled a comprehensive list of syndromes and comorbid diagnoses associated with RS and achieved expert consensus regarding the impact on early treatment decision-making for most. This list, assigned S scores, and a complete MicroNAPS calculator are publicly available at www.prscalculator.com.
Details
- Title: Subtitle
- Standardized Classification of Infants With Robin Sequence Using MicroNAPS: The Impact of Syndromes and Comorbidities
- Creators
- Cory M. Resnick - Boston Children's HospitalJody E. Heffernan - Boston Children's HospitalSnigdha Jindal - Boston Children's HospitalZaara Mehra - Boston Children's HospitalIrfan Ahmad - Children's Hospital of Orange CountyBimal Chaudhari - Nationwide Children's HospitalChristopher Cielo - Children's Hospital of PhiladelphiaNicole Deptula - Washington University in St. Louis School of MedicineZarmina Ehsan - Children's Mercy HospitalKelly N. Evans - University of WashingtonSemsa Gogcu - Brown UniversityScott E. Hickey - Nationwide Children's HospitalJeffrey S. Marschall - University of IowaMaithilee Menezes - Washington University in St. LouisDavid Molter - Washington University in St. LouisMichael A. Padula - Children's Hospital of PhiladelphiaStacey L. Peterson-Carmichael - Wake Forest UniversityStephen Alex Rottgers - Johns Hopkins All Children's HospitalChristopher M. Runyan - Wake Forest UniversityJordan W. Swanson - Children's Hospital of PhiladelphiaTara L. Wenger - University of WashingtonAndrew Deek - Boston Children's Hospital
- Resource Type
- Journal article
- Publication Details
- Plastic and reconstructive surgery. Global open, Vol.13(5), e6734
- DOI
- 10.1097/GOX.0000000000006734
- PMID
- 40321327
- PMCID
- PMC12047893
- NLM abbreviation
- Plast Reconstr Surg Glob Open
- ISSN
- 2169-7574
- eISSN
- 2169-7574
- Publisher
- Lippincott Williams & Wilkins
- Language
- English
- Date published
- 05/02/2025
- Academic Unit
- Craniofacial Anomalies Research Center; Oral and Maxillofacial Surgery
- Record Identifier
- 9984816012102771
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