title: Defining ankyloglossia: a case series of anterior and posterior tongue ties.
abstract: BACKGROUND
  Ankyloglossia is a congenital condition in which tongue mobility is limited due to an abnormality of the lingual frenulum. The impact of ankyloglossia on breastfeeding is poorly understood but there is a recent trend toward more recognition of this condition and early intervention when needed. Currently, there lacks clear definition of ankyloglossia and different subtypes have been proposed with no clinical correlation.
  
  
  OBJECTIVE
  To determine the prevalence of anterior versus posterior ankyloglossia in a large series of consecutive patients and to assess clinical outcomes after frenotomy.
  
  
  METHODS
  Retrospective chart review of patients from July 2007 to July 2009 who were diagnosed with ankyloglossia and underwent office frenotomy. Baseline characteristics, specific feeding issues, type of ankyloglossia, and clinical outcomes after frenotomy were reviewed.
  
  
  RESULTS
  Of the 341 total patients, 322 (94%) had anterior ankyloglossia and 19 (6%) had posterior ankyloglossia. Median age at presentation was 2.7 weeks (range 1 day of life to 24 weeks); 227 were males and 114 were females. Revision frenotomy rates were significantly higher for the posterior ankyloglossia group (3.7% anterior and 21.1% posterior, p=0.008).
  
  
  CONCLUSIONS
  Anterior ankyloglossia is much more common and readily managed when compared to posterior ankyloglossia. Posterior ankyloglossia is a poorly recognized condition that may contribute to breastfeeding difficulties. The diagnosis is difficult due to the subtle clinical findings but relevant health care providers should be aware of this condition. Frenotomy is a simple, safe, and effective intervention for ankyloglossia which improves breastfeeding.
authors.affiliation: Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, University of California, Children's Specialists of San Diego, 3030 Children's Way, Suite 402, San Diego, CA 92123, USA. paulbanana2000@yahoo.ca
authors.forename: Paul
authors.initials: P
authors.lastname: Hong
authors.forename: Denise
authors.initials: D
authors.lastname: Lago
authors.forename: Judi
authors.initials: J
authors.lastname: Seargeant
authors.forename: Lauren
authors.initials: L
authors.lastname: Pellman
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Magit
authors.forename: Seth M
authors.initials: SM
authors.lastname: Pransky
mesh_terms: D001942:Breast Feeding / Q000009:adverse effects; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007742:Labial Frenum / Q000473:pathology / Q000601:surgery; D008297:Male; D014059:Tongue / Q000002:abnormalities* / Q000601:surgery