Klockars Tuomas, Pitkäranta Anne
Department of Otorhinolaryngology, Helsinki University Central Hospital, Finland.
Int J Pediatr Otorhinolaryngol. 2009 Oct;73(10):1399-401. doi: 10.1016/j.ijporl.2009.07.004. Epub 2009 Aug 5.
To study the characteristics and outcome of paediatric tongue-tie division.
Retrospective analyses of 317 paediatric tongue-tie divisions (frenotomy or frenuloplasty).
Based on a questionnaire returned by 159 (51%) of patients (or guardians) the most common indication was speech/articulation problems (64%). Other indications included restricted movement (18%) and lactation/nutrition problems (8%). 84% of patients (or guardians) reported benefit from the operation. The initial surgical technique was frenotomy (no or local anaesthesia) for 34%, frenotomy (general anaesthesia) for 16%, frenuloplasty (no or local anaesthesia) for 5% and frenuloplasty (general anaesthesia) for 46% of the patients. Almost one-third of children treated with frenotomy under no or local anaesthesia needed re-operation compared to one out of 181 (0.6%) treated with frenotomy or frenuloplasty under general anaesthesia. There were no postoperative complications.
Frenotomy under no or local anaesthesia is safe and cost-effective, but one-third of children need re-operation. Adequate division of the frenulum is more important than the technique (frenuloplasty vs. frenotomy) used and seems to be easier to achieve under general anaesthesia.
研究小儿舌系带切开术的特点及结果。
对317例小儿舌系带切开术(系带切除术或系带成形术)进行回顾性分析。
根据159例(51%)患者(或监护人)返回的问卷,最常见的指征是言语/发音问题(64%)。其他指征包括活动受限(18%)和哺乳/营养问题(8%)。84%的患者(或监护人)报告手术有益。初始手术技术方面,34%的患者采用系带切除术(无麻醉或局部麻醉),16%采用系带切除术(全身麻醉),5%采用系带成形术(无麻醉或局部麻醉),46%采用系带成形术(全身麻醉)。与在全身麻醉下接受系带切除术或系带成形术的181例患者中的1例(0.6%)相比,在无麻醉或局部麻醉下接受系带切除术的儿童中近三分之一需要再次手术。无术后并发症。
无麻醉或局部麻醉下的系带切除术安全且具有成本效益,但三分之一的儿童需要再次手术。系带的充分切开比所使用的技术(系带成形术与系带切除术)更重要,并且在全身麻醉下似乎更容易实现。