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The Role of Ankyloglossia as a Protective Factor in Management of Infants With Robin Sequence

David O'Neil Danis1, Peter L Steinwald1, Andrew R Scott1,2,3

  • 1Dr. Elie E. Rebeiz Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|August 17, 2026
PubMed

Insights

Ankyloglossia (tongue-tie) may protect infants with Robin sequence (RS) from breathing problems and the need for airway interventions. This finding suggests a potential protective role for tongue-tie in managing RS complications.

Area of Science:

  • Pediatric Surgery
  • Craniofacial Anomalies
  • Neonatal Care

Background:

  • Robin sequence (RS) is a congenital anomaly characterized by micrognathia, glossoptosis, and airway obstruction.
  • Infants with RS often experience significant breathing difficulties and require interventions.
  • The role of associated conditions, such as ankyloglossia, in modifying RS outcomes is not fully understood.

Purpose of the Study:

  • To investigate the potential protective effect of ankyloglossia in infants diagnosed with Robin sequence.
  • To determine if the presence of ankyloglossia influences the severity of respiratory compromise and the need for airway interventions in RS patients.

Main Methods:

  • Retrospective analysis of a 15-year single-institution chart review of infants with RS.
  • Comparison with a larger, population-based analysis using the Kids' Inpatient Database (2016 and 2019).
  • Statistical analysis included prevalence rates and odds ratios (ORs) to quantify associations between ankyloglossia and clinical outcomes.

Main Results:

  • In the single-institution cohort, ankyloglossia was present in 8.8% of infants with RS and was associated with reduced hypoventilation, fewer airway interventions, and shorter hospital stays.
  • The nationwide analysis revealed ankyloglossia in 3.7% of RS births, showing a negative association with respiratory failure (adjusted OR 0.19) and mechanical ventilation need.
  • Ankyloglossia was significantly linked to a decreased likelihood of requiring respiratory support and airway interventions in both study cohorts.

Conclusions:

  • Ankyloglossia may serve as a protective factor in infants with Robin sequence.
  • The presence of ankyloglossia appears to reduce the risk of hypoventilation, respiratory failure, and the need for mechanical ventilation.
  • These findings highlight the importance of evaluating for ankyloglossia in infants with RS and may inform management strategies.
Abstract

Keywords:
HCUPKids' Inpatient DatabaseRobin sequenceankyloglossia

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