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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 -
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 -
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 -
Pediatric Clinics of North America Apr 2022Tethered oral tissue may represent anatomic variation or true pathology with functional limitations. The most prevalent functional limitation is impaired feeding due to... (Review)
Review
Tethered oral tissue may represent anatomic variation or true pathology with functional limitations. The most prevalent functional limitation is impaired feeding due to ankyloglossia. Treatment options include conservative management with feeding support versus intervention such as frenotomy or frenuloplasty. The benefits of intervention have yet to be fully elucidated. Many can agree that intervention may improve maternal pain during breastfeeding, but the impact of these procedures on feeding efficiency and intake is debated. Alternate ties such as posterior ankyloglossia and lip tie have been proposed as pathologic oral ties, but their true impact on feeding and speech articulation remains unclear.
Topics: Ankyloglossia; Breast Feeding; Family; Female; Humans; Lingual Frenum
PubMed: 35337536
DOI: 10.1016/j.pcl.2021.12.007 -
Tidsskrift For Den Norske Laegeforening... Sep 2021
Topics: Ankyloglossia; Breast Feeding; Female; Humans; Infant, Newborn; Tongue
PubMed: 34597009
DOI: 10.4045/tidsskr.21.0515 -
Otolaryngology--head and Neck Surgery :... Oct 2023The past 2 decades have seen a rapid increase in the diagnosis of ankyloglossia. Patients are often managed by lingual frenotomy. The objective is to define the clinical...
OBJECTIVE
The past 2 decades have seen a rapid increase in the diagnosis of ankyloglossia. Patients are often managed by lingual frenotomy. The objective is to define the clinical and socioeconomic factors that determine which patients receive frenotomy.
STUDY DESIGN
A retrospective analysis of commercially insured children.
SETTING
Optum Data Mart database.
METHODS
Trends in frenotomy including provider and setting were described. Multiple logistic regression was used to determine predictors of frenotomy.
RESULTS
Diagnosis of ankyloglossia increased from 2004 to 2019 (from 3377 in 2004 to 13,200 in 2019), while lingual frenotomy similarly increased from 1483 in 2004 to 6213 in 2019. The proportion of inpatient frenotomy procedures increased from 6.2% to 16.6% from 2004 to 2019, with pediatricians having the highest odds of performing inpatient frenotomies (odds ratio: 4.32, 95% confidence interval: 4.08, 4.57). Additionally, during the study period, the proportion of frenotomies performed by pediatricians increased from 13.01% in 2004 to 28.38% in 2019. In multivariate regression analyses, frenotomy was significantly associated with the male sex, white non-Hispanic ethnicity, higher parental income and education, and a greater number of siblings.
CONCLUSION
Ankyloglossia has been increasingly diagnosed in the past 2 decades, and among patients with ankyloglossia, frenotomy is increasingly performed. This trend was driven at least in part due to increasing rates of pediatricians as proceduralists. After accounting for maternal and patient-level clinical factors, socioeconomic differences in the management of ankyloglossia were observed.
Topics: Child; Humans; Male; United States; Infant; Ankyloglossia; Retrospective Studies; Lingual Frenum; Inpatients; Parents
PubMed: 36994937
DOI: 10.1002/ohn.332