Congenital Intraoral Synechiae: A Scoping Review of Airway, Feeding, and Surgical Management

To map the existing literature on congenital intraoral synechiae and summarize reported anatomic patterns, clinical presentation, associated anomalies/syndromes, and outcomes to inform standardized diagnostic and therapeutic approaches.

PubMed, CINAHL, Embase, Web of Science, and Google Scholar were searched from January to April 2025, supplemented by reference list screening.

This scoping review followed PRISMA-ScR recommendations. Eligible publications (1980-January 2025) were English or French reports with an abstract describing ≥1 patient with congenital intraoral soft-tissue synechiae. Two independent reviewers screened studies and extracted demographics, anatomy, symptoms, associated anomalies/syndromes, perioperative support, surgical/anesthetic techniques, and outcomes using a standardized Excel form. Data were summarized descriptively.

111 articles met the inclusion criteria, describing 134 patients. Alveolar synechiae were most common (70/134, 52.2%), followed by subglossopalatal (45/134, 33.6%) and glossopalatal (21/134, 15.7%); multiple synechiae types occurred in 10.4%. Restricted mouth opening was reported in 42.5%, feeding difficulties in 25.4%, and respiratory distress in 13.4%. Palatal clefts were present in 66.4%, and syndromic diagnoses included ankyloglossia superior syndrome and multiple pterygium syndromes (each 8.2%). Surgical excision was performed in 93.3%, most often within the first month of life. Among cases with reported outcomes, 80.6% recovered without complication; mortality was 6.7% overall, largely related to systemic disease.

Congenital intraoral synechiae demonstrate marked phenotypic heterogeneity and frequent syndromic/multisystem associations. Early multidisciplinary evaluation, proactive airway/feeding planning, and timely surgical release are central to care. However, important gaps remain in the literature, notably the lack of standardized reporting and long-term outcome data.