Stefan Johansson Posted September 25, 2018 Share Posted September 25, 2018 An interesting article just came on my radar, an international survey study on diagnosis and management of ankyloglossia (tongue-tie). The paper is Open Access in the October issue of @Acta Paediatrica, here: https://onlinelibrary.wiley.com/doi/10.1111/apa.14242 The conclusion reads Quote The diagnosis and treatment of ankyloglossia vary considerably around the world and between professions. Efforts to standardise management are required. On topic: here is a great article on Don't Forget The Bubbles (great web resource for ped fellows): https://dontforgetthebubbles.com/tongue-tie-cut/ Where I work, we are commonly consulted by midwifes about tongue.ties, and without knowing an actual rate, I'd say that we do relatively many frenectomies. We give sugar orally as analgesia and then one scissor "snip". What is your approach to the tongue-tie? Link to comment Share on other sites More sharing options...
RafaOcejo Posted October 3, 2018 Share Posted October 3, 2018 We do frenulotomies in our unit as needed. This topic is difficult to be objective about. Generally if the frenulum is short and anterior, it does interfere with breast feeding and later in life with speech develoment. We find it is better to do it early than require an ENT, dentist or general surgeon do it when the child is 2 or 3. By then the tongue is used to some movement restriction and does not regain its function right away so speech therapy needs to continue. Of interest is the genetics of the condition. Not unusual to find that a parent, a sibling or an aunt/uncle also had it or still has it and has a lisp. We anesthetize the frenulum with 4% lidocaine solution using 2 sterile Q-tips and cut the frenulum with very fine curved scissors. I have trained our pediatricians and NP’s to do it and we have not had any problems related to the procedure. Is it needed? That is where the subjective part of indications comes into play. One always feels unsure of the need. 1 Link to comment Share on other sites More sharing options...
Urban Rosenqvist Posted October 18, 2018 Share Posted October 18, 2018 An interested ENT specialist does ours within 1-2 days. As for the criterias for intervention we tend to go with: A subjective assessment of tounge tie-degree + continued feeding difficulties (even after midwife has observed and given breast feeding technique advice) and/or maternal painful nipples and/or poor weight gain. Honestly I think of it as mostly trial and error based on the factors above. We don´t use a scoring system. Those of you who do - does it help you in your decision and is this Hazelbaker scoring tool validated? 1 Link to comment Share on other sites More sharing options...
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