Treatment of ankyloglossia for reasons other than breastfeeding: a systematic review.
OBJECTIVE
Children with ankyloglossia, an abnormally short, thickened, or tight lingual frenulum, may have restricted tongue mobility and sequelae, such as speech and feeding difficulties and social concerns. We systematically reviewed literature on feeding, speech, and social outcomes of treatments for infants and children with ankyloglossia.


METHODS
Medline, PsycINFO, Cumulative Index of Nursing and Allied Health Literature, and Embase were searched. Two reviewers independently assessed studies against predetermined inclusion/exclusion criteria. Two investigators independently extracted data on study populations, interventions, and outcomes and assessed study quality.


RESULTS
Two randomized controlled trials, 2 cohort studies, and 11 case series assessed the effects of frenotomy on feeding, speech, and social outcomes. Bottle feeding and social concerns, such as ability to use the tongue to eat ice cream and clean the mouth, improved more in treatment groups in comparative studies. Supplementary bottle feedings decreased over time in case series. Two cohort studies reported improvement in articulation and intelligibility with treatment. Other benefits were unclear. One randomized controlled trial reported improved articulation after Z-frenuloplasty compared with horizontal-to-vertical frenuloplasty. Numerous noncomparative studies reported speech benefits posttreatment; however, studies primarily discussed modalities, with outcomes including safety or feasibility, rather than speech. We included English-language studies, and few studies addressed longer-term speech, social, or feeding outcomes; nonsurgical approaches, such as complementary and alternative medicine; and outcomes beyond infancy, when speech or social concerns may arise.


CONCLUSIONS
Data are currently insufficient for assessing the effects of frenotomy on nonbreastfeeding outcomes that may be associated with ankyloglossia.
Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, Tennessee; and.
Sivakumar
S
Chinnadurai
Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, Tennessee; and Center for Surgical Quality and Outcomes Research.
David O
DO
Francis
Institute for Medicine and Public Health, Evidence-based Practice Center, Departments of Psychiatry.
Richard A
RA
Epstein
General Pediatrics.
Anna
A
Morad
Ophthalmology and Visual Sciences, and.
Sahar
S
Kohanim
Institute for Medicine and Public Health, Evidence-based Practice Center, Health Policy, Vanderbilt University School of Medicine, Nashville, Tennessee melissa.mcpheeters@vanderbilt.edu.
Melissa
M
McPheeters
D000072676:Ankyloglossia; D001942:Breast Feeding; D002648:Child; D006801:Humans; D009056:Mouth Abnormalities / Q000628:therapy*; D016896:Treatment Outcome