Pediatric tongue-tie division: indications, techniques and patient satisfaction

To study the characteristics and outcome of paediatric tongue-tie division.

Retrospective analyses of 317 paediatric tongue-tie divisions (frenotomy or frenuloplasty).

Based on a questionnaire returned by 159 (51%) of patients (or guardians) the most common indication was speech/articulation problems (64%). Other indications included restricted movement (18%) and lactation/nutrition problems (8%). 84% of patients (or guardians) reported benefit from the operation. The initial surgical technique was frenotomy (no or local anaesthesia) for 34%, frenotomy (general anaesthesia) for 16%, frenuloplasty (no or local anaesthesia) for 5% and frenuloplasty (general anaesthesia) for 46% of the patients. Almost one-third of children treated with frenotomy under no or local anaesthesia needed re-operation compared to one out of 181 (0.6%) treated with frenotomy or frenuloplasty under general anaesthesia. There were no postoperative complications.

Frenotomy under no or local anaesthesia is safe and cost-effective, but one-third of children need re-operation. Adequate division of the frenulum is more important than the technique (frenuloplasty vs. frenotomy) used and seems to be easier to achieve under general anaesthesia.