Rosi-Schumacher Mattie, Ma Alison C, Reese Alyssa, Nagy Ryan, DeGiovanni Jason C, Nagy Mark, Carr Michele M
Otolaryngology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA.
Cureus. 2024 May 2;16(5):e59539. doi: 10.7759/cureus.59539. eCollection 2024 May.
The diagnosis of ankyloglossia has increased significantly around the world over the last decade. Frenotomy is indicated in infants with ankyloglossia to improve breastfeeding, although there is little scientific evidence of its efficacy. The purpose of this study is to evaluate whether infants being referred for frenotomy had feeding issues prior to the procedure.
A retrospective chart review was undertaken for all infants under one year of age referred with ankyloglossia to a pediatric otolaryngology practice or a pediatric hospital between 2018 and 2020. Data included age at referral, gender, comorbidities, feeding issues, whether ankyloglossia was diagnosed, and whether frenotomy was done. Frequencies and non-parametric comparisons were calculated.
Of the 646 consultations made for tongue tie, a diagnosis of ankyloglossia was made in 94.7% (N=612) of the patients based on clinical judgment. The most common feeding complaints were poor latch (57.1%, N=369) and painful latch (50.3%, N=325). Eighty one (12.5%) patients did not have a reported feeding difficulty. Most patients had an anterior tongue tie (85.8%, N=554), with some showing signs of restricted tongue movement (30.1%, N=184). Ankyloglossia was 4.03 times more likely to be diagnosed (p<.001) and frenotomy was 1.76 times more likely to be performed (p<.001) in the hospital setting compared to the clinic setting. Conclusion: Children under the age of one referred to otolaryngology for ankyloglossia were often diagnosed concordantly, although some lacked feeding issues that would indicate frenotomy. There are still knowledge gaps about infantile ankyloglossia in referring medical personnel.
在过去十年中，全世界范围内舌系带过短的诊断率显著上升。对于患有舌系带过短的婴儿，虽然几乎没有科学证据证明其有效性，但通常会进行舌系带切开术以改善母乳喂养。本研究的目的是评估接受舌系带切开术的婴儿在手术前是否存在喂养问题。
对2018年至2020年间转诊至儿科耳鼻喉科诊所或儿科医院的所有一岁以下患有舌系带过短的婴儿进行回顾性病历审查。数据包括转诊时的年龄、性别、合并症、喂养问题、是否诊断为舌系带过短以及是否进行了舌系带切开术。计算了频率和非参数比较。
在646例因舌系带过短进行的会诊中，根据临床判断，94.7%（N = 612）的患者被诊断为舌系带过短。最常见的喂养问题是衔乳不良（57.1%，N = 369）和衔乳疼痛（50.3%，N = 325）。81例（12.5%）患者未报告有喂养困难。大多数患者为舌前系带过短（85.8%，N = 554），部分患者表现出舌运动受限的迹象（30.1%，N = 184）。与诊所环境相比，在医院环境中诊断为舌系带过短的可能性高4.03倍（p <.001），进行舌系带切开术的可能性高1.76倍（p <.001）。结论：转诊至耳鼻喉科的一岁以下舌系带过短儿童通常得到一致的诊断，尽管有些儿童没有表明需要进行舌系带切开术的喂养问题。转诊医务人员对婴儿舌系带过短仍存在知识空白。
