Ankyloglossia: Difference between revisions - Wikipedia
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Line 13: === Feeding === Messner ''et al.''<ref name="MessnerEtal2000">{{cite journal|author =Messner, Anna H.|author2 =Lalakea, M. Lauren|author3 =Aby, Janelle|author4 =Macmahon, James|author5 =Bair, Ellen |pmid=10628708|year=2000|title=Ankyloglossia: Incidence and associated feeding difficulties|volume=126|issue=1|pages=36–9|journal=Archives of Otolaryngology–Head & Neck Surgery|doi=10.1001/archotol.126.1.36|doi-access=free}}</ref> studied ankyloglossia and infant feeding. Thirty-six infants with ankyloglossia were compared to a [[control group]] without ankyloglossia. The two groups were followed for six months to assess possible [[breastfeeding]] difficulties; defined as [[nipple]] pain lasting more than six weeks, or infant difficulty latching onto or staying onto the Wallace and Clark also studied breastfeeding difficulties in infants with ankyloglossia.<ref name="Wallace">{{cite journal|author =Wallace, Helen|author2 =Clarke, Susan|pmid=16527363|year=2006|title=Tongue tie division in infants with breast feeding difficulties|volume=70|issue=7|pages=1257–61|doi=10.1016/j.ijporl.2006.01.004|journal=International Journal of Pediatric Otorhinolaryngology}}</ref> They followed 10 infants with ankyloglossia who underwent surgical [[frenuloplasty of tongue|tongue-tie division]]. Eight of the ten mothers experienced poor infant latching onto the breast, 6/10 experienced sore nipples and 5/10 experienced continual feeding cycles; 3/10 mothers were exclusively breastfeeding. Following a tongue-tie division, 4/10 mothers noted immediate improvements in breastfeeding, 3/10 mothers did not notice any improvements and 6/10 mothers continued breastfeeding for at least four months after the [[surgery]]. The study concluded that tongue-tie division may be a possible benefit for infants experiencing breastfeeding difficulties due to ankyloglossia and further investigation is warranted. The limitations of this study include the small sample size and the fact that there was not a control group. In addition, the conclusions were based on subjective parent report as opposed to objective measures.{{ === Speech === Several recent systematic reviews and randomized control trials have determined that ankyloglossia does not impact speech sound development and that there is no difference in speech sound development between children who received surgery to release tongue-tie and those who did not. === Mechanical and social effects === Ankyloglossia can result in mechanical and social effects.<ref name="LalakeaMessner2003a" /> Lalakea and Messner<ref name="LalakeaMessner2003a" /> studied 15 people, aged 14 to 68 years old. The subjects were given [[questionnaires]] in order to assess functional complaints associated with ankyloglossia. Eight subjects noted one or more mechanical limitations which included cuts or discomfort underneath the tongue and difficulties with [[kissing]], licking Lalakea and Messner<ref name="LalakeaMessner2003b">{{cite journal |vauthors =Lalakea ML, Messner AH |title=Ankyloglossia: does it matter? |journal=Pediatr. Clin. North Am. |volume=50 |issue=2 |pages=381–97 |year=2003 |pmid=12809329 |doi=10.1016/S0031-3955(03)00029-4}}</ref> note that mechanical and social effects may occur even without other problems related to ankyloglossia, such as speech and feeding difficulties. Also, mechanical and social effects may not arise until later in childhood, as younger children may be unable to recognize or report the effects. In addition, some problems, such as kissing, may not come about until later in life.{{ === Tongue posture and mouth breathing === Line 37: ==Diagnosis== [[File:Ankyloglossia 2.jpg|thumbnail|Ankyloglossia]] According to Horton ''et al.'',<ref name="Horton" /> [[diagnosis]] of ankyloglossia may be difficult; it is not always apparent by looking at the underside of the tongue, but is often dependent on the range of movement permitted by the [[genioglossus]] muscles. For infants, passively elevating the tongue tip with a [[tongue depressor]] may reveal the problem. For older children, making the tongue move to its maximum range will demonstrate the tongue tip restriction. In addition, palpation of genioglossus on the underside of the tongue will aid in confirming the diagnosis.{{ A severity scale for ankyloglossia, which grades the appearance and function of the tongue, is recommended for use in the Academy of Breastfeeding Medicine.<ref>Hazelbaker AK: The assessment tool for lingual frenulum function (ATLFF): Use in a lactation consultant private practice Masters thesis, Pacific Oaks College, 1993</ref><ref>ABM Protocols: Protocol #11: Guidelines for the evaluation and management of neonatal ankyloglossia and its complications in the breastfeeding dyad</ref> == Treatment == There are varying types of intervention for ankyloglossia. Intervention for ankyloglossia does sometimes include surgery in the form of [[Lingual frenectomy|frenotomy]] (also called a [[frenectomy]] or [[Frenectomy|frenulectomy]]) or [[Frenuloplasty of tongue|frenuloplasty]]. This relatively common dental procedure may be done with [[Soft-tissue laser surgery|soft-tissue lasers]], such as the [[Carbon dioxide laser|CO<sub>2</sub> laser]].<ref>{{Cite web|url=https://lightscalpel.com/laser-surgery/dental-laser/|title=Laser Surgery - Soft Tissue Dentistry|website=LightScalpel}}</ref> According to Lalakea and Messner, surgery can be considered for patients of any age with a tight frenulum, as well as a history of speech, feeding, or mechanical/social difficulties. Adults with ankyloglossia may elect the procedure. Some of those who have done so report post-operative pain.{{ A viable alternative to surgery for children with ankyloglossia is to take a wait-and-see approach, especially if there are no impacts on feeding. == References == | |||