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Cureus Mar 2022The objective of this is to report a newer novel technique of harmonic scalpel frenotomy, a day care procedure under local infiltration anesthesia that could achieve...
The objective of this is to report a newer novel technique of harmonic scalpel frenotomy, a day care procedure under local infiltration anesthesia that could achieve quick bloodless adequate ankyloglossia release and excellent healing with subsequent improved articulation and speech. The procedure was performed, patient followed up for six months and excellent results noted. A 37-year-old male patient presented with type II ankyloglossia on Coryllos ankyloglossia grading scale and class III on Kotlow's assessment. A quick bloodless frenotomy with adequate release of ankyloglossia was achieved using harmonic scissors. Patient experienced no discomfort. Patient was observed for two hours and discharged the same day with chlorhexidine mouth gargles and analgesics. Postoperative healing was excellent with adequate tongue protrusion and improvement in articulation and speech. We report this newer novel technique of harmonic scissors frenotomy, a day care procedure under local infiltration anesthesia, that achieved quick bloodless adequate ankyloglossia release, excellent healing and evident improvement in articulation and speech.
PubMed: 35449686
DOI: 10.7759/cureus.23223 -
British Dental Journal Feb 2021
Topics: Ankyloglossia; Humans; Labial Frenum; Lip; Tongue
PubMed: 33574513
DOI: 10.1038/s41415-021-2679-7 -
International Journal of Pediatric... Nov 2019Ankyloglossia is an oral anomaly characterized by a shortened, thickened lingual frenulum that may cause reduced tongue mobility. However, the diagnosis and management...
INTRODUCTION
Ankyloglossia is an oral anomaly characterized by a shortened, thickened lingual frenulum that may cause reduced tongue mobility. However, the diagnosis and management of this condition has long been a debated topic. Given the paucity of high level evidence, management can be frustrating for both families and clinicians. Our study aims to examine differences in the management of ankyloglossia and investigate influencing factors at a single tertiary pediatric referral center.
METHODS
A retrospective chart review was completed of children less than one year of age seen in the outpatient otolaryngology clinic. Billing records were searched for ICD-9 code 750.0 (ankyloglossia) between January 2, 2015 and October 9, 2017 and data extracted from the charts of those meeting inclusion criteria.
RESULTS
A total of 266 charts were reviewed that met the inclusion criteria during the study period. 100 (38%) were female with a mean age of 2.9 months. In the final multivariate regression model, children seen by providers in Group 1 (providers with high rates of frenotomies) had 4.4 times the odds of having a frenotomy as those seen by a provider in Group 2 (providers with low rates of frenotomies) (p < 0.001, 95%CI: 2.2, 8.9), and male children had 2.5 times the odds of having a frenotomy as female children (p = 0.002, 95%CI: 1.4, 4.5).
CONCLUSION
In this study we identify additional variables that may influence the decision to perform a frenotomy in children with ankyloglossia. The significant impact of clinician biases in the management of ankyloglossia suggests arbitrary differences in the way these patients are managed, highlighting the lack of consensus amongst otolaryngologists and the need for clear indications and diagnostic criteria.
Topics: Ambulatory Care; Ankyloglossia; California; Clinical Decision-Making; Female; Humans; Infant; Infant, Newborn; Lingual Frenum; Male; Practice Patterns, Physicians'; Retrospective Studies; Tertiary Care Centers
PubMed: 31352228
DOI: 10.1016/j.ijporl.2019.109599 -
British Dental Journal Nov 2020
Topics: Ankyloglossia; Breast Feeding; Female; Humans; Tongue
PubMed: 33247237
DOI: 10.1038/s41415-020-2418-5 -
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 -
Nursing For Women's Health 2014This article contrasts two very different experiences of one mother breastfeeding her two sons to demonstrate the potential impact of ankyloglossia on breastfeeding....
This article contrasts two very different experiences of one mother breastfeeding her two sons to demonstrate the potential impact of ankyloglossia on breastfeeding. When too restrictive, ankyloglossia, also known as tongue-tie, can cause the newborn to ineffectively suckle at the breast. Breastfeeding difficulties can occur, such as long feedings or damaged nipples. When nurses, lactation consultants and other providers recognize this situation, they can refer women for further care and treatment, which can ultimately lead to breastfeeding success.
Topics: Ankyloglossia; Breast Feeding; Female; Humans; Infant Behavior; Infant Nutritional Physiological Phenomena; Infant, Newborn; Lingual Frenum; Male; Mothers; Mouth Abnormalities; Nipples; Nursing Assessment; Sex Factors; Social Support; Sucking Behavior
PubMed: 24750651
DOI: 10.1111/1751-486X.12108 -
Acta Paediatrica (Oslo, Norway : 1992) Oct 2018The diagnosis of tongue-tie (or ankyloglossia) has increased more than 10-fold in some countries. Whether this is a global phenomenon or related to cultural and... (Comparative Study)
Comparative Study
AIM
The diagnosis of tongue-tie (or ankyloglossia) has increased more than 10-fold in some countries. Whether this is a global phenomenon or related to cultural and professional differences is uncertain.
METHODS
An online survey in English, Japanese, Chinese and Spanish was disseminated between May and November 2016 via 27 international professional bodies to >30 clinical professions chosen a priori to represent occupations involved in the management of neonatal ankyloglossia.
RESULTS
A total of 1721 responses came from nursing (51%), medical (40%), dental (6%) and allied health (4%) clinicians. Nurses (40%) and allied health (34%) professionals were more likely than doctors (8%) to consider ankyloglossia as important for lactation problems, as were western (83%) compared to Asian (52%) clinicians. Referrals to clinicians for ankyloglossia management originated mainly from parents (38%). Interprofessional referrals were not clearly defined. Frenectomies were most likely to be performed by surgeons (65%) and dentists (35%), who were also less likely to be involved in lactation support. Clinicians performing frenectomies were more likely to consider analgesia as important compared to those not performing frenectomies.
CONCLUSION
The diagnosis and treatment of ankyloglossia vary considerably around the world and between professions. Efforts to standardise management are required.
Topics: Ankyloglossia; Attitude of Health Personnel; Breast Feeding; Feeding Behavior; Internationality; Lingual Frenum; Surveys and Questionnaires
PubMed: 29385272
DOI: 10.1111/apa.14242 -
Quintessence International (Berlin,... 2016Ankyloglossia or tongue-tie is a congenital oral anomaly with short, tight, and thick lingual frenulum. It may be asymptomatic or can cause movement limitations of the... (Review)
Review
BACKGROUND
Ankyloglossia or tongue-tie is a congenital oral anomaly with short, tight, and thick lingual frenulum. It may be asymptomatic or can cause movement limitations of the tongue, speech and articulation difficulties, breastfeeding difficulties in neonates, as well as periodontal and malocclusion problems. The etiopathogenesis of ankyloglossia is unknown; it can occur either as a sole anomaly in the vast majority or in association with other craniofacial anomalies.
OBJECTIVES
The aims of this paper were (1) to provide a comprehensive review on the criteria for clinical assessment and diagnosis, etiology and inheritance, and the therapeutic options of ankyloglossia; and (2) to demonstrate the treatment of ankyloglossia by means of frenuloplasty in three cases.
REVIEW
The available evidence from the literature indicates that among neonates, children, and adults the prevalence of ankyloglossia is low and in some cases remains undiagnosed. The early clinical assessment, diagnosis, and treatment are beneficial for the patients and their mothers.
CONCLUSIONS
Frenuloplasty is a safe, quick, effective, and economical method and for this reason the parents should not hesitate towards frenulum release. More clinical studies are needed to confirm the benefits of the surgical interventions and to compare the results with those obtained using nonsurgical therapy or with untreated cases.
Topics: Ankyloglossia; Child; Diagnosis, Differential; Female; Humans; Lingual Frenum; Male
PubMed: 27222891
DOI: 10.3290/j.qi.a36027 -
Australian Dental Journal Sep 2022It is unclear how effective tongue-tie classification assessment tools are in diagnosing symptomatic tongue-tie and fulfilling lingual frenectomy criteria. The purpose... (Review)
Review
It is unclear how effective tongue-tie classification assessment tools are in diagnosing symptomatic tongue-tie and fulfilling lingual frenectomy criteria. The purpose of this systematic review is to determine and evaluate any association between tongue-tie severity, as measured by pre-treatment assessment tools, and post-operative outcome following tongue-tie division. PubMed, EMBASE, and the Cochrane search engines were used to retrieve articles published between 1947 and 2021. Included studies consisted of patients with symptomatic tongue-tie, assessment by either the Coryllos, Kotlow, or Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF) classification tool, and tongue-tie division. A total of 205 abstracts were identified; 31 studies met the criteria for a full-text review, of which, only 14 studies met the criteria for data extraction and analysis. Six studies used the HATLFF, 2 studies used the Kotlow, 5 studies used the Coryllos, and 1 study used a combination of both Kotlow and Coryllos methods. Significant heterogeneity was evident across all studies. No statistical correlation between the two variables could be determined. Although tongue-tie division procedures appear to provide benefits in breastfeeding and speech, there are no data to suggest a statistically significant association between the severity of tongue-tie, and the correct identification of patients who would benefit from tongue-tie division. © 2022 Australian Dental Association.
Topics: Ankyloglossia; Australia; Breast Feeding; Female; Humans; Lingual Frenum; Speech
PubMed: 35689515
DOI: 10.1111/adj.12921 -
Paediatrics & Child Health Apr 2002
PubMed: 20046302
DOI: 10.1093/pch/7.4.269