Jump to content

JOIN THE DISCUSSION!

Want to join the discussions?

Sign up for a free membership! 

If you are a member already, log in!

(lost your password? reset it here)

99nicu.org 99nicu.org
Stefan Johansson

What does the world think of ankyloglossia? A relevant question!

Recommended Posts

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?

Share this post


Link to post
Share on other sites

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.

  • Like 1

Share this post


Link to post
Share on other sites

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? 

  • Like 1

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×