The Comparison of Frenulotomy with Conventional Frenuloplasty in the Management of Breastfeeding Difficulty: A Randomized Controlled Trial

Authors

  • Soratya Surijamorn Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Mongkol Laohapensang Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
  • Thidaratana Wongvisutdhi Department of Pediatric, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand

Abstract

Background: Tongue-tie is a congenital underdevelopment of the lingual frenulum and it results in decreased tongue tip mobility. Tongue-tie that is related to breastfeeding difficulty was determined to have benefit from surgical correction. The conventional frenuloplasty has been per formed under general anesthesia, although with satisfied results, the risk for anesthesia is still questioned.

Objective: To prove the efficacy of frenulotomy under local anesthesia in solving breastfeeding problems due to tongue-tie in the neonate compare with frenuloplasty under general anesthesia.

Materials and Methods: A randomized controlled study was conducted. All newborn in lactation clinic that had tongue-tie as the major cause of breastfeeding difficulties were randomized into 2 groups. Pre and post operative LATCH scores were evaluated. The increment of LATCH score indicates improvement in breastfeeding efficacy.

Results: From October 2002 to January 2003, 30 newborns were enrolled in this study. Mean increased score in frenuloplasty group was 3.07 and in frenulotomy group was 3. 13. There was no difference in increased LATCH score in both operations. No surgical complication was found in this study.

Conclusions: Frenulotomy under local anesthesia is as safe and effective procedure as frenuloplasty under general anesthesia for solving breastfeeding problems in neonate due to tongue-tie but has significant shorter time to resume breast feeding.

References

1. Messner AH. Ankyloglossia: incidence and associated feeding difficulties. Arch Otolaryngol Head Neck Surg 2000; 126: 36-9.

2. Newkirk GR. Tongue-tie snipping (frenotomy) for ankyloglossia. In: Pfenninger, editor. Procedure for primary care physician. 1st ed. St. Louis: Mosby; 1994. p. 287-90.

3. Messner AH. Ankyloglossia: controversies in management. Int Ped Otorhinolaryngol 2000; 54: 123-31.

4. Wright JE. Tongue-tie. J Pediatr Child Health 1995; 31: 276-8

5. Paradise JL. Evaluation and treatment for ankyloglossia. JAMA 1990; 263: 2371.

6. Marmet C, Shell E, Marmet R. Neonatal frenotomy may be necessary to correct breastfeeding problems. J Hum Lac 1990;6: 117-21.

7. Velanovich V. The transverse-vertical frenuloplasty for ankyloglossia: case reports. Mil Med 1994; 159: 714-5.

8. Montgomery AM. Update in maternity care: breastfeeding and postpartum maternal care. Primary care; Clinics in Office Practice 2000; 27: 237-50.

9. Delaney JE, Keels MA. Pediatric oral health: pediatric oral pathology. Soft tissue and periodontal conditions. Ped Clin North Am 2000; 47: 1125-6.

10. Charles M. Ankyloglossia. Ped Otolaryngol 1999; 7: 303.

11. Sanchez RI, Gonalez LG, Perez GV, Sanchez FL, Prado FC, Azcona Zl, et al. Section of the sublingual frenulum. Are the indications correct?. Cir Pediatr 1999: 12: 162-4.

12. Berg KL. Tongue-tie (ankyloglossia) and breastfeeding: a review. J Hum Lact 1990; 6: 109-12.

13. Saleh HA, Cain AJ, Mountain RE. Bipolar scissor division of tongue-tie under tubeless anesthesia (How I Do It: Head And Neck And Plastic Surgery: A Targeted Problem And Its Solution), Laryngol 1999; 109: 838-9.

14. Masaitis MS, Kaempf JW. Developing a frenotomy policy in one medical center: a case study approach. J Hum Lact 1996;12: 229-32.

15. Kotlow LA. Ankyloglossia (tongue-tie): a diagnostic and treatment quandary. Quintessence Int 1999; 30: 259-62.

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Published

2004-09-30

How to Cite

1.
Surijamorn S, Laohapensang M, Wongvisutdhi T. The Comparison of Frenulotomy with Conventional Frenuloplasty in the Management of Breastfeeding Difficulty: A Randomized Controlled Trial. Thai J Surg [Internet]. 2004 Sep. 30 [cited 2024 May 4];25(3):79-83. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/242398

Issue

Vol. 25 No. 3 (2004): July - September

Section

Original Articles

License

Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.