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Validation of the GILLS Score for Tongue–Lip Adhesion in Robin Sequence Patients

Abramowicz, Shelly DMD, MPH*†‡; Bacic, Janine D. MS‡§; Mulliken, John B. MD†‡; Rogers, Gary F. MD†‡

Journal of Craniofacial Surgery: March 2012 - Volume 23 - Issue 2 - p 382–386
doi: 10.1097/SCS.0b013e318240fc7b
Original Articles

Background The GILLS score consists of gastroesophageal reflux disease, preoperative intubation, late surgical intervention, low birth weight, and syndromic diagnosis. The purpose of this study was to test the validity of the GILLS score in predicting success of tongue-lip adhesion (TLA) in managing Robin sequence.

Materials and Methods Infants with Robin sequence were included in the study if they had a TLA for airway compromise subsequent to formulation of the GILLS scoring system, that is, they were not included in the original GILLS analysis. The patients were prospectively considered based on the presence of the 5 factors that constitute the GILLS score. A score of ≤2 predicts success of TLA.

Results Twenty patients met the inclusion criteria. Tongue-lip adhesion managed the compromised airway in 18 (90%) of 20 patients. Overall, the GILLS score had a sensitivity of 83%, specificity of 50%, positive predictive value of 94%, and negative predictive value of 25%.

Conclusions The GILLS score accurately predicts a successful outcome for TLA in infants with Robin sequence. For infants with a score of 2 or less, TLA is the procedure of choice. Infants with a GILLS score of 3 or greater were 5 times more likely to fail TLA than those with a score of 2 or less. In these patients, other methods of managing the airway should be considered.

From the *Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine; †Department of Plastic and Oral Surgery, Harvard Medical School; ‡Children’s Hospital Boston; and §Clinical Research Program, Boston, Massachusetts.

Received January 27, 2011.

Accepted for publication July 8, 2011.

Address correspondence and reprint requests to Shelly Abramowicz, DMD, MPH, Department of Plastic and Oral Surgery, Children’s Hospital Boston, 300 Longwood Ave, Boston, MA 02115; E-mail:

Presented at the International Society of Craniofacial Surgeons XIII International Congress and Paris Distraction Symposium; Oxford, United Kingdom; September 26–30, 2009; and at the 51st Annual Meeting of New England Society of Plastic and Reconstructive Surgeons, Hancock, MA; June 4–6, 2010.

The authors report no conflict of interest.

© 2012 Mutaz B. Habal, MD