Weill Cornell Medical College, 1300 York Ave., New York, NY, USA.
Department of Otolaryngology - Head and Neck Surgery, Weill Cornell Medicine, 1305 York Ave, 5th Floor, New York, NY, USA.
Int J Pediatr Otorhinolaryngol. 2020 Nov;138:110386. doi: 10.1016/j.ijporl.2020.110386. Epub 2020 Sep 17.
Anecdotally, there has been an increase in ankyloglossia referrals and frenotomy procedures performed in recent years. Many studies have characterized frenotomy indications and outcomes, but none have quantified how the frequency of referrals and interventions have changed over time in the outpatient setting. This study analyzes temporal trends in the diagnosis and intervention of ankyloglossia in a pediatric otolaryngology practice to further clarify how patterns of management of this condition have changed over time.
This study was a retrospective chart review of patients evaluated for ankyloglossia in an outpatient pediatric otolaryngology clinic between 2008 and 2018. The chi-square test for trend was used to assess yearly changes in the referral numbers, surgical interventions, and procedure indication prevalence proportions of interest.
Referral numbers and frenotomy procedures increased as a percentage of total office visits from 2008 to 2018 (P = 0.0026, P < 0.0001). The trend in frenotomies was especially pronounced in the 0 to 2-month age group (P < 0.0001) but was not observed in the 2 months to 1-year (P = 0.30) or 1- to 4-year (P = 0.40) age groups. Frenotomy performed for concerns of feeding (P < 0.0001) increased over the study period, but there was no significant increase in procedures performed for speech concerns (P = 0.13).
Significant increases in referrals for frenotomy and number of frenotomy procedures performed are demonstrated, especially in young infants for feeding concerns. It is unlikely representative of a true increase in the incidence of ankyloglossia, but rather the result of cultural and clinical factors driving referrals and intervention.
据传闻，近年来，舌系带过紧的转诊率和舌系带切开术有所增加。许多研究已经对舌系带切开术的适应证和结果进行了描述，但没有研究量化在门诊环境中，随时间推移转诊率和干预措施的频率如何变化。本研究分析了小儿耳鼻喉科实践中舌系带过紧的诊断和干预的时间趋势，以进一步阐明随着时间的推移，这种疾病管理模式的变化情况。
这是一项回顾性图表研究，对 2008 年至 2018 年间在小儿耳鼻喉科门诊就诊的舌系带过紧患者进行了评估。使用趋势卡方检验来评估感兴趣的转诊人数、手术干预以及手术适应证比例的逐年变化。
从 2008 年到 2018 年，转诊人数和舌系带切开术的比例呈上升趋势（P = 0.0026，P < 0.0001）。在 0 至 2 个月龄组中，舌系带切开术的趋势尤为明显（P < 0.0001），但在 2 个月至 1 岁（P = 0.30）或 1 至 4 岁（P = 0.40）年龄组中并未观察到这种趋势。出于对喂养的担忧而行舌系带切开术（P < 0.0001）的数量在研究期间有所增加，但由于言语问题而行舌系带切开术的数量没有显著增加（P = 0.13）。
证明了舌系带切开术转诊率和手术数量的显著增加，尤其是在有喂养问题的婴儿中。这不太可能代表舌系带过紧发病率的真正增加，而是由文化和临床因素推动转诊和干预的结果。
