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Children (Basel, Switzerland) Feb 2024Tongue mobility is an obstructive sleep apnoea (OSA) marker and myofunctional therapy (MFT) target. For this reason, all paediatric patients with sleep-disordered...
Tongue mobility is an obstructive sleep apnoea (OSA) marker and myofunctional therapy (MFT) target. For this reason, all paediatric patients with sleep-disordered breathing should require a combined functional assessment from an ear, nose, and throat (ENT) specialist and a phonoaudiologist to confirm or rule out the presence of ankyloglossia. To our knowledge, this is the first case of a 13-year-old girl diagnosed with severe OSA and a significant decrease of 94% in her apnoea index (AI), requiring frenotomy with an immediate postoperative change in the tongue position. A drug-induced sleep endoscopy (DISE) was performed before and immediately postfrenotomy, and the anatomical changes provoked by this surgery during sleep were confirmed for the first time.
PubMed: 38397330
DOI: 10.3390/children11020218 -
Use of Sotrovimab in Pregnancy: Experiences from the COVID-19 International Drug Pregnancy Registry.Drug Safety May 2024Available data regarding the safety and efficacy of sotrovimab in pregnant patients remain limited due to their exclusion from clinical trials.
INTRODUCTION
Available data regarding the safety and efficacy of sotrovimab in pregnant patients remain limited due to their exclusion from clinical trials.
METHODS
The COVID-19 International Drug Pregnancy Registry (COVID-PR) was established to gather comprehensive safety data from pregnant women who have received monoclonal antibody (mAb) or antiviral treatments for mild, moderate, or severe coronavirus disease 2019 (COVID-19) during pregnancy. Participants actively contributed self-reported data concerning their COVID-19 symptoms, in addition to sociodemographic and health-related characteristics. Obstetric, neonatal, and infant outcomes were also documented, with follow-up extending up to 12 months after childbirth.
RESULTS
As of 30 November 2023, sotrovimab was administered to 39 participants enrolled in the COVID-PR. At the time of this report, 26 participants had given birth, with nine deliveries performed via cesarean section. The infants' birthweight ranged from 2381 g to 4762 g, with a mean of 3439.91 g. Twenty-five infants were born at ≥37 weeks. A total of 31 adverse events (AEs) were reported by 12 participants. The most frequently reported AE was gestational hypertension, observed in three participants. COVID-19 re-infection, fatigue, gestational diabetes, headache, and morning sickness were each reported by two participants. Of the reported AEs, eight (in five participants) were classified as serious, including four AEs (prolonged labor, pre-eclampsia, polyhydramnios, premature labor) that affected pregnancy. Seven of these eight serious AEs (SAEs) were found to be unrelated to sotrovimab, with one event (urinary retention) not assessable. A total of 44 AEs were reported in 19 delivered infants or in utero fetuses. The most common were COVID-19 (n = 6 events), ear infection (n = 5 events), neonatal dyspnea (n = 3 events), and respiratory syncytial virus infection (n = 3 events). Sixteen AEs (in 11 infants/fetuses) were classified as serious, including one report each of fetal cardiac disorder, congenital ankyloglossia, persistent right umbilical vein, and congenital hydronephrosis; the latter was considered a major congenital malformation. For all assessable SAEs, causality of sotrovimab treatment was ruled out based on lack of a temporal relationship alone or in combination with absence of a plausible mechanism.
CONCLUSION
A sizable proportion of sotrovimab-treated participants in the COVID-PR had underlying medical conditions associated with an increased risk of severe COVID-19. None of the assessable SAEs were considered to be related to sotrovimab treatment.
PubMed: 38727875
DOI: 10.1007/s40264-024-01439-z -
Cureus Apr 2024Ankyloglossia, also known as tongue-tie, is a rare congenital anomaly of the oral cavity that not only causes difficulties in breastfeeding and teeth cleaning but also...
Ankyloglossia, also known as tongue-tie, is a rare congenital anomaly of the oral cavity that not only causes difficulties in breastfeeding and teeth cleaning but also causes difficulty in speech articulation. Our patient faced difficulty in freely moving his tongue because of the short lingual frenulum wherein laser lingual frenectomy was indicated. The patient was treated successfully with a soft tissue diode laser having a wavelength of 445 nanometers. The use of a low-wavelength diode laser becomes relatively complimentary to standard scalpel surgery because of patient consolation, offers a blood-free area, reduces inflammation and edema, and is less damaging to thermal tissues.
PubMed: 38752065
DOI: 10.7759/cureus.58319 -
Cureus Jul 2023Ear tags or accessory auricles are branchial cleft remnants that clinically appear as asymptomatic nodules or papules in the preauricular region. They occur in various...
Ear tags or accessory auricles are branchial cleft remnants that clinically appear as asymptomatic nodules or papules in the preauricular region. They occur in various syndromes affecting the first and branchial arches during embryogenesis. The presence of an ear tag can have a psychological impact on one's life due to its unesthetic appearance, thereby affecting their quality of life. Talon cusp usually occurs in the maxillary central or lateral incisor. A fissured tongue or cerebriform tongue is characterized by the presence of horizontal or vertical grooves, usually affecting the dorsum of the tongue. Ankyloglossia or tongue-tie is a developmental anomaly in which the lingual frenum is abnormally attached to the ventral surface of the tongue. It can cause difficulties in breastfeeding in infants and in the pronunciation of certain vowels in adults. The concurrent occurrence of the ear tag along with the talon cusp in the mandibular second molar has not been reported in previous literature. We present a unique case of a 24-year-old non-syndromic individual with the concurrent occurrence of the ear tag along with a rare clinical occurrence of talon cusp in the mandibular second molar, fissured tongue, and ankyloglossia.
PubMed: 37602049
DOI: 10.7759/cureus.42095 -
Cureus Feb 2024Ankyloglossia can be related to a number of complications, such as breastfeeding difficulties or alterations in craniofacial development. Treatment can involve surgery...
Ankyloglossia can be related to a number of complications, such as breastfeeding difficulties or alterations in craniofacial development. Treatment can involve surgery to correct the altered lingual frenulum and can be performed by various techniques. The purpose of this paper is to present two case reports of ankyloglossia in pediatric patients of different ages, the diagnostic criteria, and the treatment decision rationale, which led to a lingual frenotomy performed with a diode laser.
PubMed: 38455812
DOI: 10.7759/cureus.53701 -
Diagnostics (Basel, Switzerland) Mar 2024There were a few errors in the original publication [...].
There were a few errors in the original publication [...].
PubMed: 38535088
DOI: 10.3390/diagnostics14060608 -
Breastfeeding Medicine : the Official... Mar 2024Infants with significant retrognathia often have difficulty forming a latch adequate to establish exclusive breastfeeding. This article describes the use of at-breast...
Infants with significant retrognathia often have difficulty forming a latch adequate to establish exclusive breastfeeding. This article describes the use of at-breast supplementers (ABSs) to facilitate extended breastfeeding relationships, even when supplementation is necessary for growth. Two cases are described where infants with severe retrognathia initially struggled with weight gain necessitating supplementation but were able to ultimately exclusively feed at-breast with the use of ABSs. While the two cases differed in the form of supplemental milk used and duration of ABS use, both dyads breastfed for beyond 2 years. Feeding solely at the breast and subsequent extended breastfeeding may be possible even for infants who require supplementation, including those with anatomical or functional challenges such as retrognathia. The ABS is a relatively simple system that may be beneficial for difficulties such as poor latch and low milk supply. More awareness and education is needed so that clinicians consider supporting dyads with this approach.
Topics: Infant; Female; Humans; Animals; Breast Feeding; Retrognathia; Allergens; Milk
PubMed: 38377616
DOI: 10.1089/bfm.2023.0268 -
Special Care in Dentistry : Official... 2024Epidermolysis bullosa (EB) is a rare genetic disorder characterized by skin fragility and blister formation. The phenotypic presentation is broad with four major types,...
INTRODUCTION
Epidermolysis bullosa (EB) is a rare genetic disorder characterized by skin fragility and blister formation. The phenotypic presentation is broad with four major types, being Recessive Dystrophic EB (RDEB) the most severe, including oral anomalies such as severe microstomia, ankyloglossia, vestibule obliteration and occlusal anomalies, turning orthodontic treatment into a challenge.
AIM
This case report aims to present the comprehensive treatment of a patient with severe RDEB, including periodontal surgery, orthodontic fixed braces with mini-screws and oral rehabilitation with anterior veneers.
CASE REPORT
A 27-year-old female patient with severe RDEB received orthodontic treatment in the upper jaw to improve malalignment and anterior crossbite. After 13 months of treatment with fixed appliances, miniscrews were placed in the anterior segment to intrude and procline the upper incisors. Oral surgery was performed to increase the vestibule depth of the upper lip. Once edge-to-edge occlusion was obtained, anterior veneers were placed to improve aesthetic and stabilize occlusion, especially with the lack of posterior support.
DISCUSSION
The multidisciplinary treatment approach, involving orthodontic treatment, periodontal surgery and oral rehabilitation, played a crucial role in achieving favorable results. This case highlights the successful use of miniscrews as a viable orthodontic approach for patients with severe RDEB.
Topics: Humans; Female; Epidermolysis Bullosa Dystrophica; Adult; Bone Screws; Orthodontic Anchorage Procedures; Dental Veneers; Orthodontics, Corrective
PubMed: 38054659
DOI: 10.1111/scd.12947 -
Indian Journal of Dental Research :... Jan 2024This case report presents a rare combination of congenital anomalies in an otherwise healthy male infant born at 36 weeks. The infant was diagnosed with congenital...
RATIONALE
This case report presents a rare combination of congenital anomalies in an otherwise healthy male infant born at 36 weeks. The infant was diagnosed with congenital maxillomandibular synechia, ectrodactyly, and ankyloglossia superior syndrome (ASS).
PATIENT CONCERNS
Inability to open the mouth completely, feeding challenges, and a cleft palate. The infant was stabilized through successful positive pressure ventilation via a face mask at birth and enteral feeding was initiated via a feeding gastrostomy.
EXAMINATION
Diagnostic tests revealed a midline palatal cleft, hypoplastic jaws, persistent metopic suture, and a bony fusion at the midline.
TREATMENT
Sectioning of the bony spur along the midline and achieving a mouth opening of 2 cm post-manipulation. The patient is under follow-up, with future treatment plans including cleft palate correction at 12 months and potential frontomandibular and lower jaw advancement depending on growth trajectories.
TAKEAWAY LESSONS
This case underscores the complexity of managing multiple congenital anomalies and the need for individualized treatment plans.
Topics: Humans; Male; Cleft Palate; Tongue; Palate, Hard; Infant, Newborn; Abnormalities, Multiple; Maxilla; Ankyloglossia; Jaw Abnormalities; Mandible
PubMed: 38934763
DOI: 10.4103/ijdr.ijdr_961_23