Department of Otolaryngology, University of Rochester, Rochester, New York, U.S.A.
Advanced ENT, Voorhees, New Jersey, U.S.A.
Laryngoscope. 2021 May;131(5):E1701-E1706. doi: 10.1002/lary.29140. Epub 2020 Oct 2.
There is debate among otolaryngologists and other practitioners about whether upper lip tie contributes to difficulty with breastfeeding and whether upper lip tie and ankyloglossia are linked. Our objectives were to evaluate the anatomy of the upper lip (maxillary) frenulum, to determine if the visual anatomy of the upper lip has an effect on breastfeeding, and to determine whether the occurrence of lip tie and tongue tie are correlated.
A prospective cohort study of 100 healthy newborns was examined between day of life 3-7. Surveys were completed by the mother at the time of the initial exam and 2 weeks later. The maxillary frenulum was graded based on the Stanford and Kotlow classifications by two independent reviewers. Inter-rater reliability and relationships between tongue tie, lip tie, and the infant breastfeeding assessment tool (IBFAT) were calculated.
Inter-rater reliability showed fair agreement (κ = 0.302) using the Kotlow scale and better agreement using the Stanford classification (κ = 0.458). There was no correlation between the upper lip tie classification and breastfeeding success score. Lastly, there was a modest inverse correlation in the degree of tethering for the tongue and lip.
There was no correlation between maxillary frenulum grade and comfort with breastfeeding, pain scores, or latch. There was also no relationship between tip to frenulum length (tongue tie) and visualized lip anatomy, suggesting that tongue tie and lip tie may not cluster together in infants.
2 Laryngoscope, 131:E1701-E1706, 2021.
耳鼻喉科医生和其他从业者对唇系带是否会导致母乳喂养困难以及唇系带和舌系带是否有关联存在争议。我们的目的是评估上唇（上颌）系带的解剖结构，确定上唇的视觉解剖结构是否对母乳喂养有影响，并确定唇系带和舌系带的发生是否相关。
对 100 名健康新生儿进行前瞻性队列研究，在出生后第 3-7 天进行检查。母亲在初次检查时和 2 周后完成调查。上唇系带根据斯坦福和科特洛分类由两名独立的评审员进行分级。计算了两位评估者之间的组内相关系数和舌系带、唇系带与婴儿母乳喂养评估工具（IBFAT）之间的关系。
使用 Kotlow 量表的组内相关系数为 0.302，使用斯坦福分类的组内相关系数为 0.458，两者均显示出中等程度的一致性。上唇系带分类与母乳喂养成功率评分之间无相关性。最后，舌和唇的束缚程度呈适度的负相关。
上唇系带分级与母乳喂养舒适度、疼痛评分或含乳情况之间无相关性。舌尖至系带长度（舌系带）与可见的唇解剖结构之间也没有关系，这表明舌系带和唇系带在婴儿中可能不会聚集在一起。
2 级喉镜，131：E1701-E1706，2021 年。
