Abstract
We report a case in which a Hotz plate improved respiratory disturbance.
The patient was a 22-day-old male baby at the first examination. We diagnosed him as trisomy 21 with left cleft lip and palate. He had inspiratory stridor and insufficient oral intake, leading to him being fed 600 ml/day from a nasal tube. When we examined him the second time, he had cyanosis, retractive breathing and apnea. We decided that he needed hospital treatment, and he was admitted to our hospital. We used a Hotz plate in his mouth. We started to measure his arterial oxygen saturation SpO2 24 hours a day immediately after his admission. His arterial oxygen saturation SpO2 went down frequently after one day from the start of using the plate in his mouth. After 15 hours he could keep putting his tongue forward with the help of the plate and his respiration improved gradually. In addition, he could drink milk from a special feeding bottle designed for cleft lip and palate patients. However, he still could not take enough nutrition through oral intake only, so he was also placed under tube feeding. He was discharged as he showed improvement in respiration and sucking. He is 10 months old now and his respiration is stable. Recently, he started to eat baby food. We considered that the Hotz plate guided his tongue forward and kept it there, and the plate may have reduced his airway obstruction. Because the Hotz plate can greatly change the intra-oral condition, it might induce cyanosis temporarily. Therefore, it is necessary to pay close attention to respiration and to adjust the shape of the plate carefully depending on the case.
We concluded that the respiration was likely improved by the Hotz plate in this case.
