The University of Sydney, Sydney School of Health Sciences, Faculty of Medicine and Health, Sydney, Australia.
The University of Adelaide, School of Allied Health Science and Practice, Adelaide, Australia.
Int J Pediatr Otorhinolaryngol. 2023 Jul;170:111604. doi: 10.1016/j.ijporl.2023.111604. Epub 2023 May 19.
To investigate the prevalence and management of ankyloglossia for infants in Central Australia.
Retrospective chart review consisting of a medical file audit of infants (n = 493) <2 years old diagnosed with ankyloglossia from January 2013 to December 2018 in the primary hospital in Central Australia. Patient characteristics, reason for diagnosis, reason for procedure and outcomes of procedures routinely recorded in the patient clinical files were recorded.
The overall prevalence of ankyloglossia in this population was 10.2%. Frenotomy was performed in 97.9% of infants diagnosed with ankyloglossia. Infants with ankyloglossia were more likely to be male (58% vs 42%), diagnosed and managed with a frenotomy on the third day of life. Most ankyloglossia diagnoses were identified by a midwife (>92%). Most frenotomy procedures were completed by lactation consultants who were also midwives (99%) using blunt-ended scissors. More infants were classified with posterior ankyloglossia than anterior ankyloglossia (23% vs 15%). A frenotomy procedure resolved feeding issues in 54% of infants with ankyloglossia.
The prevalence of ankyloglossia and rate of frenotomy procedures were high when compared to previous reports in the general population. Frenotomy for ankyloglossia in infants with breastfeeding difficulties was found to be effective in more than half of the reported sample, improving breastfeeding and decreasing maternal nipple pain. A standardised approach and validated screening or comprehensive assessment tool for the identification of ankyloglossia is indicated. Guidelines and training for relevant health professionals on non-surgical management of the functional limitations of ankyloglossia are also recommended.
调查中澳地区婴儿舌系带过紧的流行情况和处理方式。
回顾性病历审查，对 2013 年 1 月至 2018 年 12 月在中澳地区一家主要医院被诊断为舌系带过紧的<2 岁婴儿（n=493）的医疗档案进行了审核。记录了患者特征、诊断原因、手术原因和手术结果，这些信息均常规记录在患者临床档案中。
该人群中舌系带过紧的总患病率为 10.2%。97.9%的确诊为舌系带过紧的婴儿接受了舌系带切开术。患有舌系带过紧的婴儿更可能为男性（58%比 42%），并在出生后第三天被诊断和接受舌系带切开术治疗。超过 92%的舌系带过紧诊断由助产士做出。99%的舌系带切开术由同时也是助产士的哺乳顾问使用钝头剪刀完成。后部舌系带过紧的婴儿多于前部舌系带过紧的婴儿（23%比 15%）。舌系带切开术可解决 54%患有舌系带过紧的婴儿的喂养问题。
与一般人群的既往报告相比，舌系带过紧的患病率和舌系带切开术的实施率均较高。对于母乳喂养困难的婴儿，舌系带切开术在报告的样本中超过一半有效，可改善母乳喂养并减少母亲乳头疼痛。需要制定一种标准化的方法和经过验证的筛查或全面评估工具来识别舌系带过紧。还建议为相关卫生专业人员提供关于舌系带过紧的非手术治疗管理的指南和培训。
