Necus Emma, Claessen Mary, Hennessey Neville, Smart Sharon
Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia.
Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia; Speech Pathology Australia, Melbourne, Victoria, Australia.
Int J Pediatr Otorhinolaryngol. 2025 Sep;196:112485. doi: 10.1016/j.ijporl.2025.112485. Epub 2025 Jul 11.
Ankyloglossia, commonly referred to as tongue tie, has become a topic of increasing interest for health care professionals and families. Global data reports a significant increase in surgical intervention to treat ankyloglossia. It is essential that professionals can identify ankyloglossia in infants accurately and reliably as a basis for providing evidence-based recommendations and intervention, and to understand better its potential impact and outcomes for infants and children.
The systematic review aimed to (i) identify assessments of tongue structure and function used to diagnose ankyloglossia in infants from birth to 12 months; (ii) evaluate the psychometric properties of these tools, and (iii) identify a comprehensive assessment tool based on the review's findings.
The Preferred Reporting Systems for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used to guide this systematic review. Searches for peer-reviewed articles were conducted on five electronic databases: Nursing and Allied Health Literature (CINAHL), ProQuest, Web of Science (WOS), Medline and Maternal and Infant Care (OVID).
A total of 117 studies met the inclusion criteria and were included in a narrative synthesis of extracted data. Nine assessment tools were identified with varying parameters of appearance and function included, as well as inconsistency in reporting of reliability and validity. Few studies used a measure of feeding as a diagnostic feature when identifying ankyloglossia in study participants.
Based on the findings from this review, the Lingual Frenulum Protocol for Infants (LFPI) had the most reported reliability and validity for the assessment of tongue structure and function and is the most comprehensive tool for ankyloglossia diagnosis. Other tools are useful screeners in clinical practice, but do not provide an in-depth assessment of feeding function. The literature overall supports the notion that a comprehensive assessment of both structure and function, including feeding impact, is required to diagnose ankyloglossia. Based on this evaluation, recommendations for surgical and/or non-surgical intervention pathways can then be considered.
舌系带过短，通常称为舌系带短缩，已成为医疗保健专业人员和家庭日益关注的话题。全球数据显示，治疗舌系带过短的手术干预显著增加。专业人员必须能够准确、可靠地识别婴儿的舌系带过短情况，以此作为提供循证建议和干预措施的基础，并更好地了解其对婴幼儿的潜在影响和结果。
本系统评价旨在：（i）确定用于诊断出生至12个月婴儿舌系带过短的舌结构和功能评估方法；（ii）评估这些工具的心理测量特性；（iii）根据评价结果确定一种综合评估工具。
采用系统评价和Meta分析的首选报告系统（PRISMA）指南指导本系统评价。在五个电子数据库中检索同行评审文章：护理与联合健康文献数据库（CINAHL）、ProQuest、科学引文索引（WOS）、医学期刊数据库（Medline）和母婴护理数据库（OVID）。
共有117项研究符合纳入标准，并纳入提取数据的叙述性综合分析。确定了九种评估工具，包括外观和功能的不同参数，以及可靠性和有效性报告的不一致性。在识别研究参与者的舌系带过短时，很少有研究将喂养指标作为诊断特征。
基于本评价结果，婴儿舌系带评估方案（LFPI）在评估舌结构和功能方面报告的可靠性和有效性最高，是诊断舌系带过短最全面的工具。其他工具在临床实践中是有用的筛查工具，但不能对喂养功能进行深入评估。总体而言，文献支持这样一种观点，即诊断舌系带过短需要对结构和功能进行综合评估，包括对喂养影响的评估。基于这一评估，然后可以考虑手术和/或非手术干预途径的建议。
