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International Journal of Pediatric... Jul 2023To investigate the prevalence and management of ankyloglossia for infants in Central Australia.
PURPOSE
To investigate the prevalence and management of ankyloglossia for infants in Central Australia.
METHOD
Retrospective chart review consisting of a medical file audit of infants (n = 493) <2 years old diagnosed with ankyloglossia from January 2013 to December 2018 in the primary hospital in Central Australia. Patient characteristics, reason for diagnosis, reason for procedure and outcomes of procedures routinely recorded in the patient clinical files were recorded.
RESULTS
The overall prevalence of ankyloglossia in this population was 10.2%. Frenotomy was performed in 97.9% of infants diagnosed with ankyloglossia. Infants with ankyloglossia were more likely to be male (58% vs 42%), diagnosed and managed with a frenotomy on the third day of life. Most ankyloglossia diagnoses were identified by a midwife (>92%). Most frenotomy procedures were completed by lactation consultants who were also midwives (99%) using blunt-ended scissors. More infants were classified with posterior ankyloglossia than anterior ankyloglossia (23% vs 15%). A frenotomy procedure resolved feeding issues in 54% of infants with ankyloglossia.
CONCLUSIONS
The prevalence of ankyloglossia and rate of frenotomy procedures were high when compared to previous reports in the general population. Frenotomy for ankyloglossia in infants with breastfeeding difficulties was found to be effective in more than half of the reported sample, improving breastfeeding and decreasing maternal nipple pain. A standardised approach and validated screening or comprehensive assessment tool for the identification of ankyloglossia is indicated. Guidelines and training for relevant health professionals on non-surgical management of the functional limitations of ankyloglossia are also recommended.
Topics: Female; Infant; Humans; Male; Child, Preschool; Ankyloglossia; Lingual Frenum; Retrospective Studies; Prevalence; Treatment Outcome; Breast Feeding; Australia
PubMed: 37224737
DOI: 10.1016/j.ijporl.2023.111604 -
Minerva Pediatrics Mar 2024Ankyloglossia is an anatomical variation of the lingual frenulum that negatively interferes with the functionality of the tongue. This condition can affect breastfeeding...
BACKGROUND
Ankyloglossia is an anatomical variation of the lingual frenulum that negatively interferes with the functionality of the tongue. This condition can affect breastfeeding negatively. The aim of this study is to assess the prevalence of ankyloglossia among healthy babies born in Siena Hospital and the correlation between ankyloglossia and breastfeeding difficulties.
METHODS
We performed an observational prospective study conducted on healthy and breastfed newborns born in Siena Hospital in the period between January and June 2022. The evaluation of lingual frenulum in the first few days of life was performed by Martinelli's Lingual Frenulum Protocol with scores for Infants (MLFPI), while the clinical assessment of breastfeeding initiation was performed by the Breastfeeding Observation and Evaluation Form according to WHO-UNICEF guidelines. We also compared the reliability in predicting breastfeeding of a tool that measured the features of the tongue frenulum: the Bristol Tongue Assessment Tool (BTT). Breastfeeding at one and six months of babies' age was assessed by telephone interview, and information among children's nutrition, weight growth and difficulties found in breastfeeding was also collected. This study was approved by the Pediatric Ethics Committee for Clinical Trials of the Tuscany Region.
RESULTS
One hundred and ninety infants were included in the study; 21 (11.05%) had a MLFPI score ≥13. Data at one month of age showed a statistically higher MLFPI score (P value <0.001) in babies with breastfeeding difficulties (median score 13.0, IQR 5.5-14), than in those without (median score 5.0, IQR 2.0-7.5). Data at 6 months of age showed a similar difference in babies with and without breastfeeding difficulties (median 12.0, IQR 4.0-14.0 vs. 5.0, IQR 2.0-8.0 respectively). A MLFPI score ≥13 is positively associated with breastfeeding difficulties at 1 and 6 months. Also, the BTT was positively a risk factor for problems in breastfeeding at 1 and 6 months.
CONCLUSIONS
A high MLFPI score is a risk factor of breastfeeding difficulties. In these cases, a referral to experienced personnel is advisable: they can provide the emotional and professional support to the mother-child dyad, and/or refer for surgical evaluation and frenotomy. In our cohort, the usefulness of either MLFPI score or BTT was evident in predicting breastfeeding difficulties; the rate of surgical removal of the frenulum was nonetheless low.
PubMed: 38536057
DOI: 10.23736/S2724-5276.23.07357-3 -
Facial Plastic Surgery Clinics of North... Feb 2024Robin sequence, macroglossia, and ankyloglossia are disorders affecting the tongue and mandible in the pediatric population. Each of these can have a significant impact... (Review)
Review
Robin sequence, macroglossia, and ankyloglossia are disorders affecting the tongue and mandible in the pediatric population. Each of these can have a significant impact on breathing, feeding, speech, dentition, and craniofacial growth. This review discusses the interdependent and coordinated development of both the tongue and mandible, the functional impacts of these disorders, and appropriate management strategies.
Topics: Humans; Child; Tongue; Macroglossia; Mandible
PubMed: 37981411
DOI: 10.1016/j.fsc.2023.08.002 -
Current Opinion in Otolaryngology &... Jun 2024The purpose of this review is to examine the current research of the posterior tongue tie and how it relates to breast feeding, solid feeding, and speech.
PURPOSE OF REVIEW
The purpose of this review is to examine the current research of the posterior tongue tie and how it relates to breast feeding, solid feeding, and speech.
RECENT FINDINGS
Recent findings show that the posterior tongue tie may play a role in effective breast feeding.
SUMMARY
Ankyloglossia is the term used for the restriction of the movement of the tongue that impairs certain functions such as breastfeeding or bottle feeding, feeding with solids, and speech. Cadaver studies have shown that there can be a restriction of the tongue and oral tissues in some people relative to others. In some breast-feeding studies, releasing the posterior tie has been shown to improve certain aspects of tongue movement. There is little evidence for or against posterior tongue ties contributing to other problems such as speech and solid feeding. This article goes into depth about the current studies on posterior ankyloglossia.
PubMed: 38869616
DOI: 10.1097/MOO.0000000000000982 -
Ear, Nose, & Throat Journal Mar 2022The relationship between ankyloglossia and speech is controversial. Our objective in the present study was to determine the most appropriate intervention and optimal...
PURPOSE
The relationship between ankyloglossia and speech is controversial. Our objective in the present study was to determine the most appropriate intervention and optimal timing for infants with speech articulation caused by ankyloglossia.
PATIENTS AND METHODS
A total of 341 pediatric patients (aged 2 to 5 years) being referred for speech concerns due to ankyloglossia were enrolled in a randomized trial and assigned to either a surgical intervention (N = 166) or a no surgical intervention (N = 175) group. Subsequently, patients were further categorized into 3 groups according to age: 2 to < 3 years, 3 to < 4 years, and 4 to < 5 years. Measures of tongue appearance, tongue mobility, speech production, and parent and clinician intelligibility ratings were collected at preintervention (T0), 2-month postintervention (T1), 6-month postintervention (T2), and 12-month postintervention (T3).
RESULTS
No statistically significant difference was found between surgical intervention and no surgical intervention groups for tongue appearance, tongue mobility, speech production, and intelligibility in the 2 to < 3 years age. However, there was significantly improved speech production and intelligibility in the surgical intervention group when compared to the no surgical intervention group in the 3 to < 4 and 4 to < 5 years old age.
CONCLUSION
Surgical intervention should not be performed too early for infants aged 2 to < 3 years with speech articulation caused by ankyloglossia, but rather watch and wait for the physiological growth of the lingual frenulum. The optimal timing range for surgical intervention is 4 to 5 years. This should provide certain significant guidance for infants with speech articulation caused by ankyloglossia.
PubMed: 35324342
DOI: 10.1177/01455613221087946 -
The Journal of Clinical Pediatric... Nov 2022To determine the prevalence of ankyloglossia in newborns with breastfeeding problems and to assess the effectiveness of frenotomy in the maintenance of exclusive...
AIM
To determine the prevalence of ankyloglossia in newborns with breastfeeding problems and to assess the effectiveness of frenotomy in the maintenance of exclusive breastfeeding at 1 month, 3 months and 6 months in newborns at an Andorran Hospital.
STUDY DESIGN
A descriptive, cross-sectional, population-based, retrospective study of newborns over a 5-year period (2016-2020) was performed. Nine medical history variables (presence or absence of ankyloglossia and type of frenulum, surgical intervention or not, first degree hereditary component, gender, Rh and blood group, type of breastfeeding, causes of cessation and duration of breastfeeding) related to perinatal and feeding history were collected confidentially and anonymously. The Coryllos classification was used for the diagnosis of ankyloglossia. Descriptive analysis of the data, Chi-square test and prevalence ratios were calculated.
RESULTS
A total of 2333 newborns were included in the study (50.02% males and 49.98% females). The prevalence of ankyloglossia was 7.84% (n = 183). Of the infants examined, 136 underwent lingual frenotomy. The number of infants who maintained exclusive breastfeeding, both surgically and non-surgically treated, was no statistically significant differences at 1 month ( = 0.65), 3 months ( = 0.61) and 6 months ( = 0.49).
CONCLUSIONS
Lingual frenotomy was only performed on patients with ankyloglossia associated with ineffective suction that causes BF difficulties. The realization or not of frenotomy was not a determining factor for the maintenance of breastfeeding at 1 month, 3 months and 6 months. On the contrary, it was a determining factor for the prolongation of mixed feeding. Ankyloglossia related to breastfeeding difficulties should be treated by a multidisciplinary team.
Topics: Infant; Male; Female; Pregnancy; Infant, Newborn; Humans; Ankyloglossia; Breast Feeding; Incidence; Retrospective Studies; Cross-Sectional Studies; Lingual Frenum
PubMed: 36624902
DOI: 10.22514/jocpd.2022.023 -
JAMA Otolaryngology-- Head & Neck... May 2022
Topics: Ankyloglossia; Humans; Tongue
PubMed: 35357423
DOI: 10.1001/jamaoto.2022.0181 -
Ankyloglossia in Monochorionic Diamniotic and Dichorionic Diamniotic Twins: A Cross-Sectional Study.Breastfeeding Medicine : the Official... Jul 2023To determine the prevalence of ankyloglossia in diamniotic monochorionic and diamniotic dichorionic twins, as well as to verify the relationship between gender and type... (Observational Study)
Observational Study
To determine the prevalence of ankyloglossia in diamniotic monochorionic and diamniotic dichorionic twins, as well as to verify the relationship between gender and type of pregnancy. A cross-sectional observational study, carried out with 52 pairs of dichorionic/diamniotic twins and 49 monochorionic/diamniotic pairs. The data collection was carried out through the analysis of medical records and the results of the Neonatal Screening of the Tongue Frenulum Assessment Protocol in Babies, and corresponded to the period of 2 years (2020-2022). Statistical analysis of data was performed, considering the significance value of 5%. The study was approved by the Human Research Ethics Committee of the institution. The statistical analysis of multiple logistic regression between the two groups of twins (Mono/Di and Di/Di) according to the socioeconomic, demographic, and clinical-epidemiological profile was statistically significant for some variables. The prevalence of ankyloglossia, according to the type of twin pregnancy, showed a statistically significant difference. There was no statistical difference in relation to sex and ankyloglossia, or between couples diagnosed with ankyloglossia according to the type of pregnancy. Monochorionic/diamniotic twins had a higher prevalence of ankyloglossia, regardless of gender.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Cross-Sectional Studies; Ankyloglossia; Breast Feeding; Twins; Pregnancy, Twin; Retrospective Studies
PubMed: 37428528
DOI: 10.1089/bfm.2022.0239 -
The Journal of Craniofacial Surgery Sep 2023Interdisciplinary evaluation is essential to diagnose and define clinical conduct for children and adults presenting with an altered lingual frenulum; however, there are... (Review)
Review
Interdisciplinary evaluation is essential to diagnose and define clinical conduct for children and adults presenting with an altered lingual frenulum; however, there are few reports on the subject in the literature. In this context, the following study exemplifies a proposed protocol for the surgical and SLT treatment of a lingual frenulum based on a review of the literature and the experience of speech and language therapists and maxillofacial surgeons from hospitals in Santiago de Chile. After its application, a history of breastfeeding with difficulties and a maintained preference for soft foods was reported. Upon anatomic examination, the lingual apex was heart-shaped, and the lingual frenulum was fixed in the upper third of the ventral side of the tongue, with a pointed shape, submerged up to the apex, and of adequate thickness. Meanwhile, upon functional examination, the tongue was descended at rest, performed tongue protrusion with restrictions (raising and clicking), did not achieve attachment or vibration, and presented distortion of the sounds / r/ and /rr/. With this information, an altered lingual frenulum was diagnosed, with the indication for surgery and postoperative speech and language therapy. The constructed instrument allowed for the standardization of the evaluation in different teams but should be validated in future research.
Topics: Child; Female; Adult; Humans; Lingual Frenum; Speech Therapy; Tongue; Breast Feeding; Tongue Diseases; Ankyloglossia
PubMed: 37427922
DOI: 10.1097/SCS.0000000000009523 -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... Feb 2023Börjeson-Forssman-Lehmann syndrome (BFLS) is a rare X-linked intellectual disability. The main features of the patients include intellectual disability/global...
Börjeson-Forssman-Lehmann syndrome (BFLS) is a rare X-linked intellectual disability. The main features of the patients include intellectual disability/global developmental delay, characteristic face, anomalies of fingers and toes, hypogonadism, linear skin hyperpigmentation, and tooth abnormalities in female patients, and obesity in male patients. A case of BFLS caused by a novel mutation of gene who was treated in the Department of Pediatrics, Xiangya Hospital, Central South University was reported. The 11 months old girl presented the following symptons: Global developmental delay, characteristic face, sparse hair, ocular hypertelorism, flat nasal bridge, hairy anterior to the tragus, thin upper lip, dental anomalies, ankyloglossia, simian line, tapering fingers, camptodactylia, and linear skin hyperpigmentation. The gene results of the second-generation sequencing technology showed that there was a novel heterozygous mutation site c.346C>T (p.Arg116*) of the (NM032458.3), variation rating as pathogenic variation. During the follow-up, the patient developed astigmatism, strabismus, awake bruxism, and stereotyped behavior, and the linear skin hyperpigmentation became gradually more evident. The disease is lack of effective therapy so far.
Topics: Humans; Male; Female; Child; Infant; Intellectual Disability; Mental Retardation, X-Linked; Obesity; Hypogonadism
PubMed: 36999477
DOI: 10.11817/j.issn.1672-7347.2023.220414