Is Ankyloglossia Correlated With Pediatric Sleep Disordered Breathing? A Systematic Review.

Area of Science:

• Pediatric Otolaryngology
• Sleep Medicine
• Developmental Pediatrics

Background:

• Sleep disordered breathing (SDB) affects 2%-11% of children, leading to neurobehavioral issues.
• Ankyloglossia (tongue-tie) is a potential risk factor for SDB, with frenotomy proposed as a treatment.
• Evaluating the evidence linking ankyloglossia and SDB in children is critical due to rising diagnoses.

Purpose of the Study:

• To critically evaluate the existing evidence for a relationship between ankyloglossia and pediatric sleep disordered breathing.
• To assess the current data supporting frenotomy as a treatment for SDB in children diagnosed with ankyloglossia.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (EMBASE, Web of Science, Medline, CINAHL, CCRCT, SCOPUS) up to February 13, 2025.
• Included studies focused on non-syndromic children aged 0-18 years, assessing the ankyloglossia-SDB relationship.
• Study quality was evaluated using the Cochrane Risk of Bias Assessment and modified Newcastle-Ottawa Scale.

Main Results:

• Evidence regarding the association between ankyloglossia and pediatric SDB is mixed and inconclusive.
• Limitations include a lack of standardized diagnostic criteria for ankyloglossia and reliance on surveys for SDB assessment.
• Insufficient data exists to support frenotomy as a treatment for SDB in this population, despite some interventional studies suggesting a positive link.

Conclusions:

• The relationship between ankyloglossia and pediatric SDB remains unclear.
• There is insufficient evidence to establish frenotomy as an indicated treatment for SDB in children with ankyloglossia.
• Future high-quality research employing standardized functional measures for ankyloglossia and validated SDB assessment tools is necessary.