Evidence and practical aspects of treatment with the Tübingen palatal plate

  • Cornelia Wiechers
    Affiliations
    Department of Neonatology, Tuebingen University Hospital, Tuebingen, Germany

    Interdisciplinary Center for Craniofacial Malformations, Tuebingen University Hospital, Tuebingen, Germany
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  • Jörg Arand
    Affiliations
    Department of Neonatology, Tuebingen University Hospital, Tuebingen, Germany

    Interdisciplinary Center for Craniofacial Malformations, Tuebingen University Hospital, Tuebingen, Germany
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  • Bernd Koos
    Affiliations
    Interdisciplinary Center for Craniofacial Malformations, Tuebingen University Hospital, Tuebingen, Germany

    Department of Orthodontics, Tuebingen University Hospital, Tuebingen, Germany
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  • Christian F. Poets
    Correspondence
    Corresponding author. Department of Neonatology, Tuebingen University Hospital, Calwerstraße 7, Tuebingen, 72076, Germany.
    Affiliations
    Department of Neonatology, Tuebingen University Hospital, Tuebingen, Germany

    Interdisciplinary Center for Craniofacial Malformations, Tuebingen University Hospital, Tuebingen, Germany
    Search for articles by this author
Published:September 17, 2021DOI:https://doi.org/10.1016/j.siny.2021.101281

      Highlights

      • TPP improves upper airway obstruction, feeding problems, growth and long-term neurocognitive outcome in infants with RS and other craniofacial malformations.
      • Based on a 3D scan of the maxilla, a TPP prototype is produced, and the length and angle of the spur are adjusted endoscopically.
      • Nutritional training and orofacial stimulation are important aspects of the Tübingen therapy concept and the majority of patients can be discharged without a feeding tube.

      Abstract

      The Tübingen therapy concept centers on an individual orthodontic palatal plate with a spur-like velar extension (Tübingen Palatal or Epiglottic Baton Plate, TPP or PEBP) and intensive feeding training. It was primarily developed for infants with Robin sequence, but has since also be used successfully in infants with other craniofacial malformations. TPP improves not only upper airway obstruction, but also feeding problems, thriving, mandibular growth and was associated with intact neurocognitive outcome. This review provides an overview of the evidence and the clinical and practical aspects of the Tübingen therapy concept.
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