Glynn R W, Colreavy M, Rowley H, Gendy S
Department of Pediatric Otorhinolaryngology, Children's University Hospital, Temple Street, Dublin 1, Ireland.
Int J Pediatr Otorhinolaryngol. 2012 Oct;76(10):1434-6. doi: 10.1016/j.ijporl.2012.06.017. Epub 2012 Jul 17.
Recent NICE guidance declared that evidence regarding surgical division of tongue tie was adequate to support the use of the procedure, provided that normal arrangements are in place for consent, audit and clinical governance. This work aimed to carry out a retrospective review of those patients who have previously undergone tongue tie division through a tertiary paediatric otorhinolaryngology service. We further aimed to identify the referral patterns, indications for, and outcomes following, division.
A retrospective chart review of all patients attending for division of tongue-tie between January 2010 and June 2011, inclusive.
A total of 48 patients underwent division of tongue-tie over the study period. The median age of patients at the time of operation was 16 months (range 3-192). Delayed speech or articulation problems (27%), and parental concern (23%) were the most common reasons for referral. Overt difficulty with feeding was responsible for referral in just 4 cases. All cases were performed under general anaesthetic as day-case procedures; 7 patients had a second procedure performed at the same time. No complications, either early or late, were recorded across this cohort.
Tongue-tie division is a safe procedure with minimal associated morbidity. Whilst the primary indication cited in the literature is that of feeding difficulty, it appears that the majority of division is performed for other reasons.
英国国家卫生与临床优化研究所(NICE)近期发布的指南宣称,只要在同意、审核及临床治理方面有正常安排,关于舌系带手术分离的证据足以支持该手术的应用。这项工作旨在对那些先前通过三级儿科耳鼻喉科服务接受过舌系带分离手术的患者进行回顾性研究。我们还旨在确定转诊模式、分离的适应症及术后结果。
对2010年1月至2011年6月期间(含)所有前来接受舌系带分离手术的患者进行回顾性病历审查。
在研究期间,共有48例患者接受了舌系带分离手术。手术时患者的中位年龄为16个月(范围3 - 192个月)。言语延迟或发音问题(27%)以及家长的担忧(23%)是最常见的转诊原因。仅有4例转诊是由于明显的喂养困难。所有病例均在全身麻醉下作为日间手术进行;7例患者同时进行了第二次手术。该队列中未记录到任何早期或晚期并发症。
舌系带分离是一种安全的手术,相关发病率极低。虽然文献中提到的主要适应症是喂养困难,但似乎大多数手术是因其他原因进行的。