Skip to main content
    • Aa
    • Aa

Tongue–lip adhesion and tongue repositioning for obstructive sleep apnoea in Pierre Robin sequence: A systematic review and meta-analysis

  • M Camacho (a1) (a2), M W Noller (a3), S Zaghi (a4), L K Reckley (a1), C Fernandez-Salvador (a1), E Ho (a5), B Dunn (a6) and D K Chan (a7)...
Abstract Objective:

To search for studies on tongue–lip adhesion and tongue repositioning used as isolated treatments for obstructive sleep apnoea in children with Pierre Robin sequence.


A systematic literature search of PubMed/Medline and three additional databases, from inception through to 8 July 2016, was performed by two authors.


Seven studies with 90 patients (59 tongue–lip adhesion and 31 tongue repositioning patients) met the inclusion criteria. Tongue–lip adhesion reduced the mean (± standard deviation) apnoea/hypopnoea index from 30.8 ± 22.3 to 15.4 ± 18.9 events per hour (50 per cent reduction). The apnoea/hypopnoea index mean difference for tongue–lip adhesion was −15.28 events per hour (95 per cent confidence interval = −30.70 to 0.15; p = 0.05). Tongue–lip adhesion improved the lowest oxygen saturation from 75.8 ± 6.8 to 84.4 ± 7.3 per cent. Tongue repositioning reduced the apnoea/hypopnoea index from 46.5 to 17.4 events per hour (62.6 per cent reduction). Tongue repositioning improved the mean oxygen saturation from 90.8 ± 1.2 to 95.0 ± 0.5 per cent.


Tongue–lip adhesion and tongue repositioning can improve apnoea/hypopnoea index and oxygenation parameters in children with Pierre Robin sequence and obstructive sleep apnoea.

Corresponding author
Address for correspondence: Dr Macario Camacho, Tripler Army Medical Center, Division of Otolaryngology and Sleep Medicine, 1 Jarrett White Rd, Honolulu, HI 96859, USA Fax: +1 808 433 9033 E-mail:
Hide All
2 M Camacho , R Capasso , S Schendel . Airway changes in obstructive sleep apnoea patients associated with a supine versus an upright position examined using cone beam computed tomography. J Laryngol Otol 2014;128:824–30

4 D Moher , A Liberati , J Tetzlaff , DG Altman . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097

7 J Cohen . Statistical Power Analysis for the Behavioral Sciences, 2nd edn. Hillsdale, NJ: Erlbaum, 1988

8 JP Higgins , SG Thompson , JJ Deeks , DG Altman . Measuring inconsistency in meta-analyses. BMJ 2003;327:557–60

9 J Lau , JP Ioannidis , CH Schmid . Quantitative synthesis in systematic reviews. Ann Intern Med 1997;127:820–6

10 RL Flores , SS Tholpady , S Sati , G Fairbanks , J Socas , M Choi The surgical correction of Pierre Robin sequence: mandibular distraction osteogenesis versus tongue-lip adhesion. Plast Reconstr Surg 2014;133:1433–9

12 AR Sedaghat , IC Anderson , BM McGinley , MI Rossberg , RJ Redett , SL Ishman . Characterization of obstructive sleep apnea before and after tongue-lip adhesion in children with micrognathia. Cleft Palate Craniofac J 2012;49:21–6

13 ST Greathouse , M Costa , A Ferrera , Y Tahiri , SS Tholpady , RJ Havlik The surgical treatment of Robin sequence. Ann Plast Surg 2016;77:413–19

14 CM Resnick , K Dentino , E Katz , JB Mulliken , BL Padwa . Effectiveness of tongue-lip adhesion for obstructive sleep apnea in infants with Robin sequence measured by polysomnography. Cleft Palate Craniofac J 2016;53:584–8

15 L Caouette-Laberge , DE Borsuk , PA Bortoluzzi . Subperiosteal release of the floor of the mouth to correct airway obstruction in Pierre Robin sequence: review of 31 cases. Cleft Palate Craniofac J 2012;49:1420

16 L Caouette-Laberge , C Plamondon , Y Larocque . Subperiosteal release of the floor of the mouth in Pierre Robin sequence: experience with 12 cases. Cleft Palate Craniofac J 1996;33:468–72

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 9
Total number of PDF views: 109 *
Loading metrics...

Abstract views

Total abstract views: 540 *
Loading metrics...

* Views captured on Cambridge Core between 14th February 2017 - 26th September 2017. This data will be updated every 24 hours.