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Major complications after tongue-tie release: A case report and systematic review

Paola Solis-Pazmino1, Grace S Kim2, Eddy Lincango-Naranjo3

  • 1Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA, USA; Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.

International Journal of Pediatric Otorhinolaryngology
|September 14, 2020
PubMed

Insights

Frenotomy for tongue-tie in infants is increasingly common, but major complications like poor feeding and airway obstruction are underreported. Further research is needed to understand risks in neonates versus older patients.

Area of Science:

  • Pediatric Surgery
  • Neonatal Care
  • Otolaryngology

Background:

  • Ankyloglossia (tongue-tie) diagnosis and frenotomy rates have surged, particularly in neonates.
  • There is ongoing debate regarding the evaluation and benefits of frenotomy for breastfeeding infants.
  • Complications associated with tongue-tie procedures are believed to be infrequent but are not well-documented.

Observation:

  • A case of a sublingual mucocele following laser frenotomy in a 6-week-old infant is presented.
  • The infant underwent the procedure performed by a dentist and subsequently developed a cyst under the tongue.
  • This case highlights a potential complication of the procedure.

Findings:

  • A systematic review identified 47 major complications in 34 pediatric patients undergoing frenotomy.
  • Common indications included breastfeeding difficulties and speech impediments.
  • Reported complications encompassed poor feeding, hypovolemic shock, apnea, airway obstruction, and Ludwig angina.

Implications:

  • There is a significant lack of comprehensive reporting on frenotomy complications.
  • The risks associated with frenotomy may differ between neonates and older pediatric populations.
  • Multidisciplinary monitoring and rigorous study are essential to inform patients and families about procedure risks and benefits.
Abstract

Keywords:
AnkyloglossiaCase reportFrenotomyFrenuloplastyLingual frenulumMajor complicationsSystematic reviewTongue-tieTongue-tie release

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