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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 -
Ear, Nose, & Throat Journal Feb 2024To analyze the effects of lingual frenotomy on adults with restrictive ankyloglossia and difficult direct laryngoscopy exposure. A case series study was conducted....
To analyze the effects of lingual frenotomy on adults with restrictive ankyloglossia and difficult direct laryngoscopy exposure. A case series study was conducted. Restriction of tongue protrusion due to ankyloglossia was identified in 2 patients who had a history of suboptimal true vocal fold (TVF) exposure on direct laryngoscopy for phonomicrosurgery. Inadequate exposure of the vocal folds was achieved on direct laryngoscopy attempts with manual tongue protrusion. Mandibular tori were not present in these patients. An intraoperative lingual frenotomy was performed in both patients. After frenotomy and with manual tongue protrusion, direct laryngoscopy exposure was substantially improved allowing for considerably more visualization of the anterior TVFs. Lingual frenulum procedures with manual tongue protrusion should be considered in select adult patients with restrictive ankyloglossia affecting optimal direct laryngoscopy exposure.
PubMed: 38380620
DOI: 10.1177/01455613231223355 -
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 -
CMAJ : Canadian Medical Association... Feb 2024
Topics: Infant; Humans; Ankyloglossia; Lingual Frenum
PubMed: 38346778
DOI: 10.1503/cmaj.230151-f -
Breastfeeding Medicine : the Official... Jan 2024
Topics: Female; Humans; Infant; Ankyloglossia; Breast Feeding; Lingual Frenum
PubMed: 38241132
DOI: 10.1089/bfm.2024.29263.editorial -
Breastfeeding Medicine : the Official... Jan 2024The prevalence of ankyloglossia and its impact on breastfeeding practices may be overestimated, leading to surgical overtreatment in newborns. The study was conducted...
The prevalence of ankyloglossia and its impact on breastfeeding practices may be overestimated, leading to surgical overtreatment in newborns. The study was conducted to estimate the prevalence of ankyloglossia in the first year of life and investigate the association with exclusive and total breastfeeding duration in different regions of Brazil. This multicenter prospective cohort study involved the recruitment of mother-infant pairs soon after childbirth in public hospitals in three state capitals in Brazil. Interviews were held with the mothers after birth, at 6 and 12 months to collect sociodemographic variables and data on exclusive and total breastfeeding duration. At 12 months of age, the children were submitted to a dental examination for classification of the lingual frenulum using the Bristol Tongue Assessment Tool. Data analysis involved Poisson regression with robust variance, with the calculation of unadjusted and adjusted relative risk (RR). The final sample was composed of 293 children. The prevalence of defined and suspected ankyloglossia was 1% and 4.8%, respectively, totaling 5.8% (confidence interval [95% CI]: 3.1-8.5). No significant difference was found in the prevalence of exclusive and total breastfeeding at 1, 4, and 6 months between children with defined/suspected ankyloglossia and those without ankyloglossia. The multivariable analysis showed that the probability of the child achieving 6 months of breastfeeding did not differ between groups (RR = 0.98; 95% CI: 0.79-1.23; = 0.907). The prevalence of defined ankyloglossia was very low and defined/suspected ankyloglossia was not associated with exclusive or total breastfeeding duration. Registered with clinicaltrials.gov (n° NCT03841123).
Topics: Infant; Female; Child; Infant, Newborn; Humans; Ankyloglossia; Breast Feeding; Cohort Studies; Prospective Studies; Lingual Frenum; Prevalence
PubMed: 38241126
DOI: 10.1089/bfm.2023.0182 -
Otolaryngology--head and Neck Surgery :... May 2024Assess the relationship between public interest in ankyloglossia as determined by internet search volume and real-world medical claims data.
OBJECTIVES
Assess the relationship between public interest in ankyloglossia as determined by internet search volume and real-world medical claims data.
STUDY DESIGN
Retrospective Cohort Study.
SETTING
This retrospective cohort study was conducted using claims data from the Merative™ Marketscan® Research Databases. The internet search data was collected from Google Trends.
METHODS
Annual Google Trends data were compiled using search terms associated with "ankyloglossia" and "frenotomy" for the years 2011 to 2021. We obtained incidence of ankyloglossia diagnoses and frenotomy procedures in children under 12 months from Marketscan relative to all infants enrolled. We compared associations between search and incidence data among US states and over time.
RESULTS
Google search correlated with ankyloglossia incidence (r = 0.4104, P = .0031) and with frenotomy incidence (r = 0.4062, P = .0034) per state. Ankyloglossia diagnoses increased with Google search index (coefficient = 0.336, 95% confidence interval [CI] 0.284, 0.388) and year (coefficient = 0.028, 95% CI 0.025, 0.031). Similarly, frenotomy procedures increased with Google search index (coefficient = 0.371, 95% CI 0.313, 0.429) and year (coefficient = 0.027, 95% CI 0.024, 0.030).
CONCLUSIONS
Associations between online ankyloglossia search trends and both diagnosis and treatment rates, persist across US regions and timeframes. Internet search trends are pivotal in shaping pediatric health care decisions, driving clinical consensus, and disseminating evidence-based information.
Topics: Humans; Ankyloglossia; Retrospective Studies; Infant; United States; Female; Internet; Male; Incidence; Infant, Newborn; Databases, Factual
PubMed: 38219744
DOI: 10.1002/ohn.643 -
International Journal of Pediatric... Jan 2024Ankyloglossia or tongue tie is a condition where the lingual frenulum restricts tongue movement, negatively impacting breastfeeding. An increasing number of infants...
OBJECTIVES
Ankyloglossia or tongue tie is a condition where the lingual frenulum restricts tongue movement, negatively impacting breastfeeding. An increasing number of infants diagnosed with ankyloglossia may lead to unnecessary procedures. To limit the overtreatment of this problem, we established a specialist clinic to provide the best available evidence-based care to the mother-infant dyad.
METHODS
We discuss the development of a specialist tongue tie assessment clinic in our unit.
RESULTS
From January to October 2023, there were 162 visits to the clinic by 157 patients. During this time, there were 96 frenotomies performed.
CONCLUSIONS
The mother-infant dyad is a vulnerable patient group. Establishing a specialist tongue tie assessment clinic with otolaryngology and lactation expertise provides the best available evidence-based care.
Topics: Infant; Infant, Newborn; Female; Humans; Ankyloglossia; Lingual Frenum; Breast Feeding; Mothers; Ambulatory Care Facilities
PubMed: 38157706
DOI: 10.1016/j.ijporl.2023.111843 -
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 -
Journal of Clinical Medicine Nov 2023(1) Background: The incidence of ankyloglossia is 0.02-10.7%. Its effect on selected dysfunctions has been described; however, no studies report its impact on several...
(1) Background: The incidence of ankyloglossia is 0.02-10.7%. Its effect on selected dysfunctions has been described; however, no studies report its impact on several disorders in a group of subjects. The aim of this study was to assess the effect of ankyloglossia on swallowing, speech, occlusion and periodontium. (2) Methods: The study group consisted of 86 patients with ankyloglossia, and the control group (n = 86) had a normal tongue frenulum. Type of swallowing, tongue mobility, speech, occlusion and periodontium were assessed. (3) Results: Ankyloglossia pertained to 75.6% patients with infantile swallowing and 41.3% patients with mature swallowing. Limited tongue mobility was found in 29.4% subjects with moderate ankyloglossia and 70.6% subjects with severe ankyloglossia. All subjects with mild ankyloglossia and all the controls had normal tongue mobility. The relationship between dysglossia and ankyloglossia severity was statistically significant. Malocclusion or crowding was diagnosed in 62% subjects with ankyloglossia and 21.6% subjects in the control group. No periodontal abnormalities were found in any subject. (4) Conclusions: (1) A short tongue frenulum negatively influences swallowing and is associated with an "infantile swallowing pattern". (2) Moderate or severe ankyloglossia significantly limits tongue mobility. (3) A short tongue frenulum negatively influences speech. (4) Ankyloglossia is associated with higher prevalence of malocclusion.
PubMed: 38068467
DOI: 10.3390/jcm12237415