title: Outpatient division of tongue-tie without anesthesia in infants and children.
abstract: BACKGROUND
  Tongue-tie is a common but often neglected condition. The indications and the techniques for its division are still controversial. In this report, I will present my personal experience and advocate early and aggressive treatment.
  
  
  METHODS
  Two different techniques are used to divide the tongue-tie at the outpatient clinic without anesthesia. For small infants, a parent sits opposite the doctor, with their knees in contact, the infant lies supine with his/her head towards the doctor. The tongue is lifted superiorly with the doctor's middle finger or middle and index fingers. The doctor uses the other hand to divide the tongue-tie with a pair of blunt-tipped scissors. In a cooperative child with teeth and relatively thin membrane, a sitting position is used. The tongue is elevated upward with a tongue depressor and the tongue-tie is released by a quick cut.
  
  
  RESULTS
  From 1980 to 2006, about 2800 cases of tongue-tie were treated. Post-division minor bleeding in most of the cases was self-limited and always stopped spontaneously very quickly. Three patients who had recurrent tongue-tie underwent repeated division in the operating room under general anesthesia.
  
  
  CONCLUSIONS
  Division of tongue-tie is a simple, easy and safe procedure. It can be done as an outpatient procedure without anesthesia in almost all infants and some older children.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan, China. ed103434@edah.org.tw
authors.forename: Ming-Lun
authors.initials: ML
authors.lastname: Yeh
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000758:Anesthesia; D002648:Child; D006488:Hemostasis, Surgical; D006801:Humans; D007223:Infant; D008035:Lingual Frenum / Q000002:abnormalities* / Q000601:surgery*; D016896:Treatment Outcome