Application of the MicroNAPS Classification for Robin Sequence

Abstract

Objective The only findings consistent among infants with Robin sequence (RS) are the presence of micrognathia, glossoptosis, and upper airway obstruction (UAO). Feeding and growth dysfunction are typical. The etiopathogenesis of these findings, however, is highly variable, ranging from sporadic to syndromic causes, with widely disparate levels of severity. This heterogeneity has created inconsistency within RS literature and debate about appropriate workup and treatment. Despite several attempts at stratification, no system has been broadly adopted. Design We recently presented a novel classification that is summarized by the acronym MicroNAPS. Each of 5 elements is scored: Micrognathia, Nutrition, Airway, Palate, Syndrome/comorbidities, and element scores are summarized into a “stage”. Results Testing of this system in a sample of 100 infants from our center found it to be clinically relevant and to predict important management decisions and outcomes. Conclusions We herein present an interactive website ( www.prscalculator.com ) and printable reference card for simple application of MicroNAPS, and we advocate for this classification system to be adopted for clinical care and research.