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Published on: November 6, 2019
Objective Improvement After Frenotomy for Posterior Tongue-Tie: A Prospective Randomized Trial
Bobak A Ghaheri1, Douglas Lincoln2, Tuyet Nhi T Mai3
1Division of Otolaryngology, The Oregon Clinic, Portland, Oregon, USA.
Insights
Frenotomy for posterior tongue-tie (PTT) significantly improves infant feeding metrics and maternal outcomes. This surgical release addresses a valid clinical concern, enhancing both infant and mother well-being.
Area of Science:
- Pediatric surgery
- Lactation consulting
- Neonatology
Background:
- Posterior tongue-tie (PTT) significantly impacts infant feeding, causing difficulties in breastfeeding and bottle-feeding.
- Objective data on the postoperative effects of PTT release (frenotomy) is limited.
- Ankyloglossia, commonly known as tongue-tie, requires further investigation regarding effective treatment outcomes.
Purpose of the Study:
- To quantify the postoperative impacts of frenotomy for posterior tongue-tie (PTT) using objective feeding metrics.
- To evaluate the effectiveness of PTT release on infant feeding function and patient-reported outcomes.
- To provide objective data addressing the dearth of research on ankyloglossia treatment.
Main Methods:
- A prospective randomized controlled trial was conducted with infants aged 3 to 16 weeks diagnosed with PTT.
- Infants were divided into an observational/control arm (n=23) and an interventional/surgical treatment arm (n=24).
- Tongue function was objectively measured using a specialized bottle-feeding system, supplemented by validated patient-reported outcome measures.
Main Results:
- The interventional group showed statistically significant improvements in 11 objective feeding metrics by day 10 post-frenotomy.
- Improvements included faster tongue speed, more coordinated sucking, and enhanced tongue adaptability.
- Patient-reported outcomes revealed significant improvements in breastfeeding self-efficacy and reduced infant reflux and nipple pain in the surgical group.
Conclusions:
- Frenotomy for posterior tongue-tie (PTT) leads to measurable improvements in infant feeding parameters within 10 days.
- Objective and patient-reported outcomes confirm the benefits of PTT release for both infants and mothers.
- Posterior tongue-tie is a significant clinical issue, and surgical intervention effectively alleviates infant and maternal symptoms.
Objective:
Infants with posterior tongue-tie (PTT) can have substantial difficulty with breastfeeding and bottle-feeding. This study aimed to address the dearth in investigational objective data surrounding PTT release to better quantify the postoperative impacts of frenotomy for ankyloglossia.
Study Design:
Prospective randomized, controlled trial.
Setting:
Private practice clinic.
Methods:
In a prospective, randomized controlled trial, infants 3 to 16 weeks of age with PTT undergoing frenotomy were examined using a bottle-feeding system capable of objectively measuring tongue function. Validated patient-reported outcome measures were also obtained simultaneously.
Results:
Forty-seven infants with PTT were enrolled into an observational/control arm (n = 23) or interventional/surgical treatment arm (n = 24). The total cohort consisted of 29 (61.7%) male infants with a median age of 39 days. At the day 10 time point, the interventional arm demonstrated statistically significant improvement in 11 objectively obtained feeding metrics, indicating faster tongue speed, more rhythmic and coordinated sucking motions, and a tongue more capable of adapting to varying feeding demands. Significant improvement in breastfeeding self-efficacy was reported in the interventional group while poor self-confidence persisted in the observational group. Infant reflux symptoms improved in the interventional group while not in the control group. Nipple pain also persisted in the control group but improved in the surgical cohort.
Conclusions:
When measured 10 days after frenotomy for PTT, infants improve feeding parameters using an objective bottle-feeding system. Similar improvements are seen with patient-reported outcomes when PTT is released. Posterior tongue-tie is a valid clinical concern, and surgical release can improve infant and maternal symptoms.
