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舌系带过紧的新生儿行舌系带激光切开术:一项前瞻性队列研究。

Lingual laser frenotomy in newborns with ankyloglossia: a prospective cohort study.

机构信息

Complex Unit of Odontostomatology, University of Bari Aldo Moro, Bari, Italy.

Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy.

出版信息

Ital J Pediatr. 2022 Sep 5;48(1):163. doi: 10.1186/s13052-022-01357-9.

Abstract

BACKGROUND

The study aims to describe the lingual laser frenotomy perioperative protocol for newborns with ankyloglossia with or without breastfeeding difficulties developed by Odontostomatology and Neonatology and Neonatal Intensive Care Units of the Aldo Moro University of Bari.

METHODS

Authors carried out a prospective observational cohort study. Newborns with ankyloglossia (classified by using both Coryllos' and Hazelbaker's criteria) with or without difficult breastfeeding (according to Infant Breastfeeding Assessment Tool) underwent diode laser frenotomy (800 ± 10 nm; 5 W; continuous wave mode; contact technique; under topical anesthesia) and follow-up visits after seven and thirty days postoperatively. The authors analyzed as main outcomes the perioperative pain intensity measured by the C.R.I.E.S. scale, the occurrence of complications and quality of healing, the quality of breastfeeding, newborn's postoperative weight gain, maternal nipple pain, and the presence of lesions as secondary outcomes.

RESULTS

Fifty-six newborns were included in the current study. Intraoperative mean pain intensity was 5.7 ± 0.5 points, resolved within thirty postoperative minutes. Observed complications were mild punctuating bleeding, carbonization of the irradiated site, and transitory restlessness. All wounds were completely healed within the thirtieth postoperative day. During follow-up, a significant breastfeeding improvement was evident with satisfactory newborns' weight gain and a significant reduction of nipple pain and lesions (p < .05).

CONCLUSION

Our lingual laser frenotomy protocol provided significant breastfeeding improvement in the mother-newborn dyads with low intraoperative pain and no significant complications.

摘要

背景

本研究旨在描述巴里阿尔多·莫罗大学的口腔颌面外科和新生儿科以及新生儿重症监护病房制定的用于治疗舌系带过紧的新生儿的舌侧激光系带切开术围手术期方案。

方法

作者开展了一项前瞻性观察队列研究。对伴有或不伴有母乳喂养困难的舌系带过紧的新生儿(根据 Coryllos 和 Hazelbaker 的标准分类)行二极管激光系带切开术(800±10nm;5W;连续波模式;接触技术;局部麻醉),并在术后 7 天和 30 天进行随访。作者分析了主要结局为 C.R.I.E.S. 量表评估的围手术期疼痛强度、并发症和愈合质量、母乳喂养质量、新生儿术后体重增加、产妇乳头疼痛以及作为次要结局的损伤情况。

结果

本研究共纳入 56 例新生儿。术中平均疼痛强度为 5.7±0.5 分,术后 30 分钟内缓解。观察到的并发症为轻度点状出血、照射部位碳化和短暂烦躁不安。所有伤口均在术后第 30 天完全愈合。随访时,母乳喂养显著改善,新生儿体重增加满意,乳头疼痛和损伤显著减少(p<0.05)。

结论

我们的舌侧激光系带切开术方案为母婴提供了显著的母乳喂养改善,术中疼痛低,无明显并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adab/9446865/90253654b6d4/13052_2022_1357_Fig1_HTML.jpg

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