Ankyloglossia: Last three-years of outpatient care at a tertiary referral center

LeTran, Vivian; Osterbauer, Beth; Buen, Floyd; Yalamanchili, Ronica; Gomez, Gabriel

doi:10.1016/j.ijporl.2019.109599

Cited by 10 publications

(22 citation statements)

References 9 publications

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“…However, ankyloglossia may be overdiagnosed and aggressively treated by wellmeaning health professionals. [6][7][8][9] We seek to evaluate in this study whether rates of diagnosis and treatment of ankyloglossia have continued to increase in the United States since 2012 or whether these rates have since reached an inflection point.…”

mentioning

confidence: 99%

Ankyloglossia: Update on Trends in Diagnosis and Management in the United States, 2012‐2016

Wei

Tunkel

Boss

et al. 2020

Otolaryngol.--head neck surg.

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Ankyloglossia, or “tongue-tie,” refers to limited tongue mobility caused by a restrictive lingual frenulum. Previous studies have demonstrated rapid increases in diagnosis and treatment of ankyloglossia in the United States up to 2012. We performed an updated retrospective review of data from the National Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality (AHRQ) to evaluate trends in diagnosis of ankyloglossia and use of lingual frenotomy in the hospital setting. From 2012 to 2016, there was an 110.4% increase in reported diagnosis of ankyloglossia in the inpatient setting with similar increases in lingual frenotomy procedures. As seen previously, sex, type of insurance, median income ZIP code, and geographic region were associated with diagnosis of ankyloglossia. The observed trends from prior to 2012 have continued to increase, while unanswered questions about diagnostic criteria and about which infants should undergo frenotomy remain.

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mentioning

confidence: 99%

Ankyloglossia: Update on Trends in Diagnosis and Management in the United States, 2012‐2016

Wei

Tunkel

Boss

et al. 2020

Otolaryngol.--head neck surg.

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“…In fact, LeTran et al found that in clinicians with known high rates of frenotomy, there was a 4.4 times greater likelihood that a patient with ankyloglossia would receive treatment. 1 Lisonek et al noted some regions in Canada have quadruple as many frenotomies as surrounding areas. 11 Further, in our project there was no correlation between the number of procedures and the number of years in practice, which suggests that this trend is not generational.…”

Section: Discussionmentioning

confidence: 99%

“…Ankyloglossia, "tongue tie," is a condition in which the lingual frenulum is shortened or thickened. 1 The prevalence ranges from 3-16% due to many asymptomatic cases remaining undiagnosed. 2 Ankyloglossia has the potential to interfere with speech articulation as well as oral tasks like chewing; 3 however, the biggest factor is di culty breastfeeding, particularly maternal nipple discomfort.…”

Section: Introductionmentioning

confidence: 99%

Trends in Treatment of Ankyloglossia: A Survey Based, Provider Perspective on Current Practice Trends

Goosmann

Aviles

Shah

2022

Preprint

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Background Ankyloglossia, “tongue tie,” is a condition in which the lingual frenulum is shortened. Ankyloglossia can interfere with speech articulation as well as tasks like chewing or playing an instrument; however, the biggest factor is difficulty breastfeeding. To treat ankyloglossia, providers perform frenectomy or frenotomy. With minor bleeding and recurrence as the common complications, frenotomies are generally well received by providers and parents. This survey polled provider preferences and views on the ankyloglossia treatments. Methods Proceeding IRB approval. A 22-question survey on treatment and trends for ankyloglossia was sent to SENTAC (Society for Ear Nose Throat Advancement in Children) members. Questions addressed area of sub-specialization, years in practice, type of practice, performance of frenotomy and frenectomy, criteria for surgical repair, procedure frequency and change over time, and individual comments. Results Of the 62 respondents, there was a difference between use of frenotomy vs frenectomy (94.3% vs 38.6%) p<0.001. Common provider criteria for the procedure were improvement of pain with breastfeeding and improvement latching, followed by future speech concerns. Of respondents, 94% reported that they would repair anterior ties; 63% of respondents perceived an increase of frenotomies in the past five years both in their practice and in the practice of colleagues. Respondents also reported an increase in parents asking about tongue ties. Conclusion Treatment of this condition tends to be very provider dependent/regional. The results from this survey in association with the new consensus statement will lead towards the creation of a clinical care pathway that would stabilize these numbers and create a stream-lined process.

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“…The other important determination on the rate of frenotomy within an institution is the clinicians themselves. With a lack of concrete diagnostic and therapeutic criteria, studies have demonstrated signi cant inter clinician variability in deciding to perform or not to perform frenotomy in infants with ankyloglossia 22 . In the last number of years performing frenotomy has become a lucrative private practice.…”

Section: Discussionmentioning

confidence: 99%

Friend or Frenotomy: A Single Institution’s Experience With Ankyloglossia

Corbett

Cleere

Patil

et al. 2021

Preprint

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Introduction/AimAnkyloglossia, or ‘tongue-tie’, is a common congenital anomaly in which a short lingual frenulum or genioglossus muscle restricts tongue movement. Ankyloglossia can be graded from 1 (most severe) to 4 (least severe). The effects of ankyloglossia can include breastfeeding and articulation issues; however, many infants will have no symptoms or developmental problems. The surgical intervention for ankyloglossia is frenotomy. This can be performed in the outpatient setting in small infants. Ankyloglossia referrals in neonates and small infants necessitate an urgent referral to the ear nose and throat (ENT) clinic in order to facilitate breast feeding and weight gain. We sought to analyse the ankyloglossia service in a district general hospital setting from referral to outpatient clinic. MethodsWe retrospectively analysed a consecutive cohort of babies referred to the Ear Nose and Throat service for consideration of frenotomy over an 18 month period, We analysed data from referral including demographics and clinical information, we recorded information from the clinical consultation and procedure details if frenotomy was performed.ResultsBetween 1 January 2019 and 31 January 2021 referrals were made for consideration of frenotomy, all appointments were seen within 2 weeks. 55.3% of referrals were sent from public health nurses, 25.5% from primary care, 10.6% from lactation consultants and 8.5% from paediatric consultants. Of 47 referrals, a frenotomy was performed in 30 babies. All frenotomies were performed without complications.ConclusionInformation on ankyloglossia is varied and available information is conflicting, without any clear standardised guideline or treatment algorithm. Referral indications can be unclear and result in unnecessary clinic appointments in an already heavily burdened service. Frenotomy can be performed safely by a trained clinician in an outpatient setting with minimal equipment.

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Ankyloglossia: Last three-years of outpatient care at a tertiary referral center

Cited by 10 publications

References 9 publications

Ankyloglossia: Update on Trends in Diagnosis and Management in the United States, 2012‐2016

Ankyloglossia: Update on Trends in Diagnosis and Management in the United States, 2012‐2016

Trends in Treatment of Ankyloglossia: A Survey Based, Provider Perspective on Current Practice Trends

Friend or Frenotomy: A Single Institution’s Experience With Ankyloglossia

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