Clinical Consensus Statement: Ankyloglossia in Children

@article{Messner2020ClinicalCS,
 title={Clinical Consensus Statement: Ankyloglossia in Children},
 author={Anna H. Messner and Jonathan M. Walsh and Richard M. Rosenfeld and Seth Roslow Schwartz and Stacey L. Ishman and Cristina M Baldassari and Scott E. Brietzke and David H. Darrow and Nira A. Goldstein and Jessica R. Levi and Anna K. Meyer and Sanjay R. Parikh and Jeffrey P. Simons and Daniel L. Wohl and Erin M Lambie and Lisa Satterfield},
 journal={Otolaryngology–Head and Neck Surgery},
 year={2020},
 volume={162},
 pages={597 - 611},
 url={https://api.semanticscholar.org/CorpusID:215759225}
}
This expert panel reached consensus on several statements that clarify the diagnosis, management, and treatment of ankyloglossia in children 0 to 18 years of age.

147 Citations

Ankyloglossia: Conscientious Use of Best Evidence Amid the Controversy
The letter authors express concern that the CCS had a duty ‘‘to include more stakeholders and experts than they elected to’’ and explicitly supports the concept that the presence of restrictive tongue movement from ankyloglossia is a possible component of breastfeeding efficacy.

Feeding Issues in Infants Referred for Frenotomy
Children under the age of one referred to otolaryngology for ankyloglossia were often diagnosed concordantly, although some lacked feeding issues that would indicate frenotomy.

Ankyloglossia as an interdisciplinary problem
The interdisciplinary discussion enabled a broader look at the subject of the frenulum of the tongue and enabled the development of an algorithm for dealing with ankyloglossia, which will greatly facilitate the work of doctors, speech therapists and physiotherapists.

Alternative Therapies for Ankyloglossia-Associated Breastfeeding Challenges: A Systematic Review
Although some studies suggest the potential benefits of combining alternative therapies with surgery for AG-related breastfeeding issues, the lack of control groups renders the evidence inconclusive and nonsurgical approaches alone currently lack sufficient evidence.

Effects of different surgical treatments on children with ankyloglossia: protocol for a systematic review and meta-analysis
A systematic review and meta-analysis will summarise relevant information on the effects of different surgical treatments on patients with ankyloglossia and the improvement of breast feeding and nipple pain will be the primary outcome.

Response to Letter Regarding Cordray et al. (2023) and Brief Commentary on the Ankyloglossia Debate.
A scoping review of potentially related symptoms in pediatric patients who presented for clinical evaluation of untreated ankyloglossia drew a provisional conclusion that ankyloglossia may be associated with speech difficulty in a subset of patients; it did not assert any causal relationship.
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124 References

Ankyloglossia: facts and myths in diagnosis and treatment.
The lack of an accepted definition and classification of ankyloglossia makes comparisons between studies almost impossible and it also remains controversial which tongue-ties need to be surgically removed and which can be left to observation.

Diagnosis and Treatment of Ankyloglossia in Newborns and Infants: A Review
Consistent terminology with emphasis on symptomatic ankyloglossia and a uniform grading system, such as the Hazelbaker Assessment Tool for Lingual Frenulum Function and Coryllos grading, are needed to improve the quality of research in the future.

Ankyloglossia: a morphofunctional investigation in children.
Length of frenulum and interincisal distance allow an assessment of severity of ankyloglossia in children and investigates the correlation between severity and morphofunctional findings.

Treatment of Ankyloglossia and Breastfeeding Outcomes: A Systematic Review
A small body of evidence suggests that frenotomy may be associated with mother-reported improvements in breastfeeding, and potentially in nipple pain, but with small, short-term studies with inconsistent methodology, strength of the evidence is low to insufficient.

Defining Tip–Frenulum Length for Ankyloglossia and Its Impact on Breastfeeding: A Prospective Cohort Study
Tonga tip–frenulum length correlated with maternal nipple pain, and was useful as an objective tool for identifying newborns at risk for ankyloglossia, and should be interpreted with caution when evaluating newborns for posterior tongue tie.

Treatment of Ankyloglossia for Reasons Other Than Breastfeeding: A Systematic Review
Data is currently insufficient for assessing the effects of frenotomy on nonbreastfeeding outcomes that may be associated with ankyloglossia, and few studies addressed longer-term speech, social, or feeding outcomes.
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