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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 -
CoDAS 2024To analyze the influence of ankyloglossia on the prevalence and duration of exclusive breastfeeding of full-term infants up to the sixth month of life.
PURPOSE
To analyze the influence of ankyloglossia on the prevalence and duration of exclusive breastfeeding of full-term infants up to the sixth month of life.
METHODS
Prospective cohort study, carried out with 225 mother-infant dyads who were followed up in the first six months of life in a center specialized in breastfeeding in a tertiary hospital. Full-term infants with asymptomatic ankyloglossia (no need for surgery) were compared with infants without change at monthly follow-up. Ankyloglossia was diagnosed using the Bristol Tongue Assessment Tool, with a positive diagnosis being considered for those with a score less than or equal to 5 considering functional and anatomical aspects. Statistical analyzes were performed using descriptive statistics, logistic regression (weaning determinants), relative risk, and survival curves (to analyze breastfeeding duration between groups with and without ankyloglossia).
RESULTS
Ankyloglossia was associated with weaning (considered even partial) before the sixth month of life. After adjusted analysis, a higher risk of weaning was detected in infants with this alteration, with a risk present from the second month of life. In the survival analysis, the duration of breastfeeding in infants with ankyloglossia was shorter when compared to children without alterations.
CONCLUSION
Compared to infants with normal lingual frenulum, babies with ankyloglossia had shorter exclusive breastfeeding time, but well above the average observed in the general population. The risk of weaning for this group was also higher.
Topics: Humans; Breast Feeding; Ankyloglossia; Prospective Studies; Infant, Newborn; Female; Male; Infant; Time Factors; Cohort Studies; Adult; Lingual Frenum; Weaning; Prevalence; Brazil; Risk Factors
PubMed: 38922259
DOI: 10.1590/2317-1782/20242023108pt -
Cureus May 2024The diagnosis of ankyloglossia has increased significantly around the world over the last decade. Frenotomy is indicated in infants with ankyloglossia to improve...
INTRODUCTION
The diagnosis of ankyloglossia has increased significantly around the world over the last decade. Frenotomy is indicated in infants with ankyloglossia to improve breastfeeding, although there is little scientific evidence of its efficacy. The purpose of this study is to evaluate whether infants being referred for frenotomy had feeding issues prior to the procedure.
METHODS
A retrospective chart review was undertaken for all infants under one year of age referred with ankyloglossia to a pediatric otolaryngology practice or a pediatric hospital between 2018 and 2020. Data included age at referral, gender, comorbidities, feeding issues, whether ankyloglossia was diagnosed, and whether frenotomy was done. Frequencies and non-parametric comparisons were calculated.
RESULTS
Of the 646 consultations made for tongue tie, a diagnosis of ankyloglossia was made in 94.7% (N=612) of the patients based on clinical judgment. The most common feeding complaints were poor latch (57.1%, N=369) and painful latch (50.3%, N=325). Eighty one (12.5%) patients did not have a reported feeding difficulty. Most patients had an anterior tongue tie (85.8%, N=554), with some showing signs of restricted tongue movement (30.1%, N=184). Ankyloglossia was 4.03 times more likely to be diagnosed (p<.001) and frenotomy was 1.76 times more likely to be performed (p<.001) in the hospital setting compared to the clinic setting. Conclusion: Children under the age of one referred to otolaryngology for ankyloglossia were often diagnosed concordantly, although some lacked feeding issues that would indicate frenotomy. There are still knowledge gaps about infantile ankyloglossia in referring medical personnel.
PubMed: 38826893
DOI: 10.7759/cureus.59539 -
Cureus Apr 2024A lingual frenectomy is a surgical procedure aimed at addressing "tongue-tie" or ankyloglossia, where a strip of tissue restricting tongue movement is removed....
A lingual frenectomy is a surgical procedure aimed at addressing "tongue-tie" or ankyloglossia, where a strip of tissue restricting tongue movement is removed. Typically, this strip extends from the bottom of the mouth to the underside of the tongue. The procedure, often performed using a diode laser, offers several advantages including simplicity and safety for patients. It can significantly improve speech articulation and eating for individuals with ankyloglossia. This case report highlights the successful treatment of a female patient experiencing speech difficulties with diode laser therapy for tongue-tie.
PubMed: 38826594
DOI: 10.7759/cureus.59412 -
IEEE Journal of Translational... 2024Identify infants with abnormal suckling behavior from simple non-nutritive suckling devices.
OBJECTIVE
Identify infants with abnormal suckling behavior from simple non-nutritive suckling devices.
BACKGROUND
While it is well known breastfeeding is beneficial to the health of both mothers and infants, breastfeeding ceases in 75 percent of mother-child dyads by 6 months. The current standard of care lacks objective measurements to screen infant suckling abnormalities within the first few days of life, a critical time to establish milk supply and successful breastfeeding practices.
MATERIALS AND METHODS
A non-nutritive suckling vacuum measurement system, previously developed by the authors, is used to gather data from 91 healthy full-term infants under thirty days old. Non-nutritive suckling was recorded for a duration of sixty seconds. We establish normative data for the mean suck vacuum, maximum suck vacuum, suckling frequency, burst duration, sucks per burst, and vacuum signal shape. We then apply computational methods (Mahalanobis distance, KNN) to detect anomalies in the data to identify infants with abnormal suckling. We finally provide case studies of healthy newborn infants and infants diagnosed with ankyloglossia.
RESULTS
In a series of case evaluations, we demonstrate the ability to detect abnormal suckling behavior using statistical analysis and machine learning. We evaluate cases of ankyloglossia to determine how oral dysfunction and surgical interventions affect non-nutritive suckling measurements.
CONCLUSIONS
Statistical analysis (Mahalanobis Distance) and machine learning [K nearest neighbor (KNN)] can be viable approaches to rapidly interpret infant suckling measurements. Particularly in practices using the digital suck assessment with a gloved finger, it can provide a more objective, early stage screening method to identify abnormal infant suckling vacuum. This approach for identifying those at risk for breastfeeding complications is crucial to complement complex emerging clinical evaluation technology.
CLINICAL IMPACT
By analyzing non-nutritive suckling using computational methods, we demonstrate the ability to detect abnormal and normal behavior in infant suckling that can inform breastfeeding intervention pathways in clinic.Clinical and Translational Impact Statement: The work serves to shed light on the lack of consensus for determining appropriate intervention pathways for infant oral dysfunction. We demonstrate using statistical analysis and machine learning that normal and abnormal infant suckling can be identified and used in determining if surgical intervention is a necessary solution to resolve infant feeding difficulties.
Topics: Humans; Machine Learning; Infant, Newborn; Infant; Female; Sucking Behavior; Male; Signal Processing, Computer-Assisted; Breast Feeding
PubMed: 38765888
DOI: 10.1109/JTEHM.2024.3390589 -
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 -
Ugeskrift For Laeger Apr 2024Ankyloglossia or tongue-tie is a condition where the anatomical variation of the sublingual frenulum can limit normal tongue function. In Denmark, as in other countries,... (Review)
Review
Ankyloglossia or tongue-tie is a condition where the anatomical variation of the sublingual frenulum can limit normal tongue function. In Denmark, as in other countries, an increase in the number of children treated for ankyloglossia has been described over the past years. Whether or not ankyloglossia and its release affect the speech has also been increasingly discussed on Danish television and social media. In this review, the possible connection between ankyloglossia, its surgical treatment, and speech development in children is discussed.
Topics: Humans; Ankyloglossia; Child; Language Development; Tongue; Lingual Frenum; Speech; Infant
PubMed: 38704717
DOI: 10.61409/V11230699 -
International Journal of Surgery Case... May 2024Plastic surgeons can help to eliminate stunting by surgically treating children born with congenital craniofacial anomalies such as tongue-tie, or ankyloglossia....
INTRODUCTION
Plastic surgeons can help to eliminate stunting by surgically treating children born with congenital craniofacial anomalies such as tongue-tie, or ankyloglossia. Releasing ankyloglossia can help to support breastfeeding and the later development of orofacial anatomy and physiology. Failure to do so can lead to growth and development difficulties in children. We report a heartbreaking case of a stunted 8 year-old female with underdiagnosed and untreated ankyloglossia.
PRESENTATION OF CASE
The patient was consulted with a short stature, speech disorder, and swallowing disorder. History taking and physical examination led to a diagnosis of type 4 (posterior) ankyloglossia. The Hazelbaker Assessment Tool for Lingual Frenulum Function mandated a frenotomy. Under general anesthesia, frenotomy was performed surgically, and significant tongue mobility was gained.
DISCUSSION
This case alerted both surgeon and pediatrician that collaboration is a must to intervene in such a specific congenital anomalies. Posterior (type 4) ankyloglossia may cause difficulties in tongue mobility which can lead to difficulties in breastfeeding and swallowing, speech disorders, and malocclusion. Posterior ankyloglossia is not only the most severe form of ankyloglossia, but also the most difficult to diagnose.
CONCLUSION
In the absence of social and environmental factors, posterior (type 4) ankyloglossia was the single most responsible factor in this growth and development delay in the girl. Timely diagnosis and treatment could have prevented such a stunted condition.
PubMed: 38653172
DOI: 10.1016/j.ijscr.2024.109648 -
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 -
Sleep & Breathing = Schlaf & Atmung Jun 2024Recent studies have highlighted the potential role of a short lingual frenulum as a risk factor for pediatric obstructive sleep apnea syndrome. A shortened frenulum may... (Meta-Analysis)
Meta-Analysis
PURPOSE
Recent studies have highlighted the potential role of a short lingual frenulum as a risk factor for pediatric obstructive sleep apnea syndrome. A shortened frenulum may contribute to abnormal orofacial development, leading to increased upper airway resistance and susceptibility to upper airway collapsibility during sleep. Recognizing early indicators, such as a short lingual frenulum, is crucial for prompt intervention. This systematic review aims to evaluate the association between a short lingual frenulum and the risk of obstructive sleep apnea syndrome in children.
METHODS
This systematic review adheres to PRISMA criteria for a quantitative analysis. A comprehensive search was conducted on five databases until January 2024 to identify relevant studies. The selected articles underwent rigorous analysis, considering study design, sample characteristics, lingual frenulum characterization, sleep assessment methods, and key findings.
RESULTS
A total of 239 references were initially identified. Finally, six studies were included in the qualitative synthesis, with four studies eligible for the quantitative synthesis. The Newcastle-Ottawa scale was employed to assess study quality. Meta-analysis, supported by a moderate evidence profile according to the GRADE scale, revealed statistically significant differences, with odds ratios of 3.051 (confidence interval: 1.939 to 4.801) for a short frenulum and 12.304 (confidence interval: 6.141 to 24.653) for a high-arched palate.
CONCLUSION
This systematic review and meta-analysis provide evidence supporting the association between ankyloglossia and obstructive sleep apnea in children. Nevertheless, it is crucial to consider additional factors such as tongue mobility and the presence of a high-arched palate in further evaluations.
Topics: Child; Humans; Ankyloglossia; Sleep Apnea, Obstructive
PubMed: 38478208
DOI: 10.1007/s11325-024-03021-4