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Brazilian Journal of Otorhinolaryngology 2022To investigate the evidence on the association between ankyloglossia and obstructive sleep apnea. (Review)
Review
OBJECTIVES
To investigate the evidence on the association between ankyloglossia and obstructive sleep apnea.
METHODS
An integrative literature review was carried out in the databases. Observational and interventional studies that assessed the lingual frenulum in children with sleep-disordered breathing were included. As exclusion criteria: studies in animals, in vitro, letters to the editor, expert opinions, other reviews. The selected articles were analyzed regarding the study design, sample, characterization of the lingual frenulum and sleep assessment, in addition to the main results and conclusions.
RESULTS
Ninety-seven articles were identified, but only 4 met the inclusion criteria. Two retrospective studies concluded that the untreated shortened lingual frenulum at birth is associated with obstructive sleep apnea. A prospective study concluded that there was an improvement in speech and deglutition after lingual frenectomy, in addition to improved sleep. A retrospective cohort concluded that lingual frenuloplasty combined with myofunctional therapy is effective in the treatment of snoring and mouth breathing.
CONCLUSION
The studies included in this review contribute to corroborate the association between ankyloglossia and obstructive sleep apnea.
Topics: Humans; Retrospective Studies; Prospective Studies; Sleep Apnea, Obstructive
PubMed: 34895868
DOI: 10.1016/j.bjorl.2021.09.008 -
Frontiers in Pediatrics 2023The most common symptom attributed to ankyloglossia is difficulty breast feeding due to poor latch, inefficient milk extraction and/or maternal nipple pain. During the... (Review)
Review
The most common symptom attributed to ankyloglossia is difficulty breast feeding due to poor latch, inefficient milk extraction and/or maternal nipple pain. During the past two decades, despite a declining birth rate, there has been a dramatic increase in the number of infants diagnosed with and treated for ankyloglossia in the United States, Canada and Australia. Despite a dramatic increase in the diagnosis and treatment of ankyloglossia in these countries, there remains no universally agreed upon definition of ankyloglossia and none of the published scoring systems have been rigorously validated. However ankyloglossia is defined, the majority of infants with ankyloglossia are asymptomatic. Perhaps, infants with ankyloglossia have a greater incidence of difficulty breast feeding. Lingual frenulotomy may decrease maternal pain and at least transiently improve the quality of breast feeding in some infants however no published studies take into account the fact that sucking and feeding are soothing to infants and the observed improvements immediately following frenulotomy may be a response to the pain associated with the procedure rather than a result of the procedure itself. While there are almost certainly some infants in whom tongue-tie interferes with breast-feeding, there is currently no good evidence lingual frenulotomy leads to longer duration of breast-feeding. Frenulotomy appears to be a generally safe procedure however there are reports of serious complications. Finally, there are no studies of long-term outcomes following frenulotomy during infancy and given traditional thinking that the lingual frenulum is a cord of connective tissue tethering the tongue to the floor of the mouth may be incorrect and the frenulum contains motor and sensory branches of the lingual nerve, the procedure may be less benign than previously thought.
PubMed: 37181430
DOI: 10.3389/fped.2023.1086942 -
Advances in Neonatal Care : Official... Apr 2016Our current culture defines breastfeeding and the use of human breast milk as the preferred criterion standard for infant nutrition. Medical and health professionals... (Review)
Review
BACKGROUND
Our current culture defines breastfeeding and the use of human breast milk as the preferred criterion standard for infant nutrition. Medical and health professionals have a responsibility to support breastfeeding in the mother-infant dyad. This includes the recognition of anatomical barriers to breastfeeding such as a tongue-tie, ankyloglossia.
PURPOSE
The purpose of this article is to enrich and expand the clinical knowledge of health professionals about the physical assessment of ankyloglossia and its impact on breastfeeding. Techniques for assessing anterior and posterior ankyloglossia and interventions across the spectrum are discussed. We also explore maternal emotional experiences of breastfeeding an infant with ankyloglossia.
METHODS/SEARCH STRATEGY
A systematic literature search from MEDLINE, CINAHL, and Cochrane databases was performed. The search results consisted of qualitative and quantitative studies performed involving infants with anykloglossia and breastfeeding experiences. Data and findings from the search results were analyzed and reviewed.
FINDINGS
Ankyloglossia, commonly referred to as tongue-tied, can result in weight loss, painful breastfeeding, and a cessation of breastfeeding prematurely. Depending on severity, interventions to alleviate breastfeeding difficulties can range from a lactation consultation to surgical intervention. The options for treatment and intervention must be discussed thoroughly with caregivers.
IMPLICATIONS FOR PRACTICE
Thorough assessment of the breastfeeding dyad is essential to discovering ankyloglossia and its role in breastfeeding difficulties. Intervening appropriately can prevent negative outcomes associated with ankyloglossia and breastfeeding.
IMPLICATIONS FOR RESEARCH
Future studies should be focused on developing universal tools for grading ankyloglossia and the effects of ankyloglossia on speech development. There is also a gap in the knowledge regarding ankyloglossia in the preterm infant and its impact on developing breast and bottle-feeding technique in the neonatal intensive care unit.
Topics: Ankyloglossia; Breast Feeding; Humans; Infant, Newborn; Lingual Frenum; Oral Surgical Procedures; Referral and Consultation
PubMed: 27003478
DOI: 10.1097/ANC.0000000000000252 -
CMAJ : Canadian Medical Association... Feb 2024
Topics: Infant; Humans; Ankyloglossia; Lingual Frenum
PubMed: 38346778
DOI: 10.1503/cmaj.230151-f -
Clinics in Perinatology Sep 2023Breastfeeding is the biologic norm for newborn feeding, and exclusive breastfeeding for the first 6 months of life is universally endorsed by leading global and... (Review)
Review
Breastfeeding is the biologic norm for newborn feeding, and exclusive breastfeeding for the first 6 months of life is universally endorsed by leading global and national organizations. Despite these recommendations, many people do not meet their breastfeeding goals and controversies surrounding breastfeeding problems exist. Medical issues can present challenges for the clinician and parents to successfully meet desired feeding outcomes. There are studies evaluating these common controversies and medical conundrums, and clinicians should provide evidence-based recommendations when counseling families about newborn feeding.
Topics: Infant, Newborn; Female; Humans; Infant; Breast Feeding
PubMed: 37536775
DOI: 10.1016/j.clp.2023.04.003 -
Clinical Case Reports Jun 2017This case report describes a patient with ankyloglossia, oligodontia, unilateral hypoplasia of the zygoma and mandible, along with bilateral distal reduction anomalies...
This case report describes a patient with ankyloglossia, oligodontia, unilateral hypoplasia of the zygoma and mandible, along with bilateral distal reduction anomalies of his limbs without long bone abnormalities. This may represent a mild variant of oromandibular limb hypogenesis syndrome, expanding the phenotypic spectrum, or a previously unrecognized malformation syndrome.
PubMed: 28588849
DOI: 10.1002/ccr3.956 -
Revista Paulista de Pediatria : Orgao... 2017To critically examine the existing Brazilian and International scientific literature regarding the influence of short lingual frenulum over growth and development of the... (Review)
Review
OBJECTIVE
To critically examine the existing Brazilian and International scientific literature regarding the influence of short lingual frenulum over growth and development of the stomatognathic system, as well as how it impacts the achievement of the shape-function balance.
DATA SOURCES
An electronic literature search was conducted in databases, including MEDLINE/PubMed, Google Scholar, LILACS, SciELO, and ScienceDirect, using the key words "lingual frenum" and "development", as well as their equivalents in Brazilian Portuguese. The literature search yielded 51 papers published between January 1997 and the present date; 14 articles of clinical trials were selected for meeting the inclusion criteria and were read in full.
DATA SYNTHESIS
The integrated literature review supported the proposition that some malocclusions are closely related to the presence of ankyloglossia and, although very few clinical trials on this topic have been published so far, there is a consensus among authors concerning the negative effects of functional imbalances over the stomatognathic system's proper growth and development. Half of the studies found state that surgical interventions for releasing the lingual frenum are both safe and effective, concerning improvement in breastfeeding scores. Moreover, 4 out of the 14 studies included in this integrated review, report a negative influence of ankyloglossia over the orofacial muscular system.
CONCLUSIONS
There is a consensus among the authors concerning the negative effects of lingual frenulum's anatomic and functional alterations over craniofacial growth and development. The opinion about the early surgical intervention, however, is not unanimous.
Topics: Adolescent; Ankyloglossia; Child; Child, Preschool; Female; Humans; Infant; Male; Stomatognathic System
PubMed: 28977337
DOI: 10.1590/1984-0462/;2017;35;2;00016 -
Journal of the American Dental... Jan 2024Ankyloglossia is a congenital alteration that affects the tongue's mobility, influencing craniofacial development; however, its association with malocclusion is still... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Ankyloglossia is a congenital alteration that affects the tongue's mobility, influencing craniofacial development; however, its association with malocclusion is still unclear. This systematic review and meta-analysis investigated the association between ankyloglossia and malocclusion in patients.
TYPES OF STUDIES REVIEWED
The authors conducted a systematic review and meta-analysis of observational studies that investigated the association between malocclusion and the presence of ankyloglossia in any age group, used any assessment tool to diagnose ankyloglossia, and considered all types of malocclusion. The authors conducted searches in 8 electronic databases through July 1, 2022. They used Joanna Briggs Institute appraisal tools to assess the methodological quality and the Grading of Recommendations, Assessment, Development and Evaluations approach to assess the certainty of the evidence.
RESULTS
Eleven studies (5 cross-sectional, 6 case-control) included 2,904 patients and over 13 occlusal alterations. The certainty of the evidence ranged from low through very low. Patients with Angle Class III malocclusion had similar or more inserted lingual frenula than patients with Class I malocclusion (standard mean difference, 0.37; 95% CI, -0.50 to 1.25) and Class II malocclusion (standard mean difference, 0.55; 95% CI, -0.52 to 1.63). Patients with Class III malocclusion had clinically significant increased mouth opening reduction compared with patients with Class I malocclusion (mean difference, 6.67; 95% CI, 4.01 to 9.33) and Class II malocclusion (mean difference, 5.04; 95% CI, 2.35 to 7.72) patients.
PRACTICAL IMPLICATIONS
There is uncertain evidence that ankyloglossia may be associated with the development of occlusal alterations. Ankyloglossia did not influence the Angle classification. Clinicians should closely follow children with ankyloglossia to evaluate whether this condition interferes with the occlusion. Future research should prospectively follow up on the long-term association between ankyloglossia and malocclusion. The protocol was registered a priori in the PROSPERO database (CRD42021248034). No amendments were deemed necessary after the registration of the protocol. Some subgroup analyses planned a priori were not possible, such as the severity of ankyloglossia, sex, and age, due to the lack of studies reporting data for these subgroups.
Topics: Child; Humans; Ankyloglossia; Cross-Sectional Studies; Malocclusion; Malocclusion, Angle Class III; Malocclusion, Angle Class II
PubMed: 37999659
DOI: 10.1016/j.adaj.2023.09.014 -
Children (Basel, Switzerland) Dec 2023This is a literature review of ankyloglossia and its correlation with lactation problems. Ankyloglossia, commonly referred to as tongue-tie, brings about functional... (Review)
Review
This is a literature review of ankyloglossia and its correlation with lactation problems. Ankyloglossia, commonly referred to as tongue-tie, brings about functional difficulties and, in some cases, may lead to early weaning. It is crucial to use breastfeeding as the exclusive food source for the first six months of an infant's life, and the interference of the tongue contributes substantially to success in this regard. Even though there are many publications about ankyloglossia, there are still many controversies about its definition, diagnosis, classification, and treatment decision determined via frenotomy. Some researchers state that the identification of ankyloglossia should be based on morphological and anatomical evidence, while others claim that a short or tight frenulum should be examined in correlation with the impact on the mother-infant dyad during breastfeeding. By encouraging and supporting mothers in coping with feeding difficulties, their lactation experiences are improved, and they can continue breastfeeding.
PubMed: 38136104
DOI: 10.3390/children10121902 -
Pediatric Annals Aug 2021Ankyloglossia, commonly called "tongue-tie," has been increasingly diagnosed in the breast-feeding infant, with growing numbers of surgical interventions in the last 2...
Ankyloglossia, commonly called "tongue-tie," has been increasingly diagnosed in the breast-feeding infant, with growing numbers of surgical interventions in the last 2 decades. As more practitioners have become involved in the diagnosis and treatment, there has not been a consensus on terminology and indications for intervention. In 2020, the American Academy of Otolaryngology - Head and Neck Surgery Foundation reviewed the bodies of lactation, dental, pediatric, and otolaryngology literature to seek professional consensus and note areas requiring more definitive evidence. This article highlights the findings for the general pediatrician seeking to support breast-feeding dyads. .
Topics: Ankyloglossia; Breast Feeding; Female; Humans; Infant; Lingual Frenum; Otolaryngology; Pediatricians
PubMed: 34398711
DOI: 10.3928/19382359-20210715-01