Feeding Examination Can Avert Surgical Frenotomy Procedures

Most patients referred for ankyloglossia can benefit from intervention strategies other than surgical procedures, according to a study published online in JAMA Otolaryngology-Head & Neck Surgery.

Christen Caloway, M.D., from the Massachusetts Eye and Ear Infirmary in Boston, and colleagues followed mother-infant dyads who were referred for difficulty with breastfeeding. Infants underwent comprehensive feeding evaluation by speech and language pathologists who examined the ability to breastfeed before surgical consultation. The percentage of frenotomy procedures was examined as the primary outcome following implementation of a multidisciplinary feeding team evaluation.

A total of 115 infants were referred for surgical division of the lingual frenum. The researchers found that 62.6 percent of patients subsequently did not undergo surgical procedures following the development of a program with feeding examination with a pediatric speech and language pathologist. All of the referrals were for lingual frenotomy, but 8.7 and 27.8 percent underwent labial frenotomy alone and both labial and lingual frenotomy, respectively.

"This evidence can be used to objectively inform parents on expectations when considering appropriate intervention in the setting of a comprehensive, multidisciplinary evaluation for frenotomy," the authors write.

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