Our Summary

This research paper is about a condition called ankyloglossia, also known as tongue-tie, where a baby is born with a short or thick tongue that limits its movement. This can cause issues with breastfeeding, like latching difficulties, nipple pain, and poor milk supply in mothers. It can also lead to health and developmental issues for the baby, like oral hygiene problems, speech difficulties, and social consequences.

The condition is more common in boys and affects between 4 to 10% of babies in the UK and USA. There isn’t a standard way to diagnose it, but there are some tools that doctors can use. The severity of tongue-tie can vary from mild to severe, and it can occur at the front or back of the tongue. It can also happen alongside other conditions like a lip-tie.

One way to treat tongue-tie is through a procedure called a frenectomy, which involves cutting the tongue-tie. This can be done with a laser, scalpel, or surgical scissors. Another procedure is a frenuloplasty, which involves more precise incisions and wound closure. There has been an increase in frenectomies in recent years, possibly due to greater awareness and better diagnosis.

However, there is disagreement about when and if a tongue-tie should be cut to help with breastfeeding. Not all breastfeeding issues are caused by tongue-tie, and in some cases, cutting the tongue-tie might not solve the problem. Some babies’ tongues might adapt and stretch over time, improving breastfeeding without needing surgery. Some health organizations suggest that surgery might not be needed unless the baby is having significant breastfeeding issues.

The paper aims to review the current evidence on the effectiveness of frenectomy for babies with tongue-tie, as well as the guidelines for using this procedure.

FAQs

  1. What is ankyloglossia or tongue-tie and how common is it?
  2. What are the possible treatments for tongue-tie in babies?
  3. What is the current medical consensus on performing a frenectomy in cases of tongue-tie?

Doctor’s Tip

A helpful tip a doctor might tell a patient about z-plasty is to follow post-operative care instructions carefully to promote proper healing and minimize scarring. This may include keeping the incision site clean and dry, avoiding excessive movement or stretching of the area, and taking any prescribed medications as directed. It’s also important to attend follow-up appointments with the doctor to monitor progress and address any concerns.

Suitable For

Patients who are typically recommended for a z-plasty procedure are those with ankyloglossia or tongue-tie, especially infants experiencing difficulties with breastfeeding due to limited tongue movement. The severity of the tongue-tie and the specific breastfeeding issues the baby is facing will also be taken into consideration when determining if a z-plasty procedure is necessary. It is important for healthcare providers to carefully assess each individual case and weigh the potential benefits and risks of the procedure before making a recommendation for z-plasty.

Timeline

Before Z-plasty:

  1. Baby is born with ankyloglossia (tongue-tie) which limits tongue movement.
  2. Mother may experience breastfeeding issues such as latching difficulties, nipple pain, and poor milk supply.
  3. Health and developmental issues for the baby may arise, such as oral hygiene problems, speech difficulties, and social consequences.
  4. Diagnosis of tongue-tie may be made using various tools.
  5. Severity of tongue-tie can vary from mild to severe, and it can occur at the front or back of the tongue.

After Z-plasty:

  1. Procedure is performed to treat the tongue-tie, such as a frenectomy or frenuloplasty.
  2. Tongue-tie is cut using a laser, scalpel, or surgical scissors.
  3. More precise incisions and wound closure may be done in a frenuloplasty.
  4. Increase in frenectomies in recent years due to greater awareness and better diagnosis.
  5. Disagreement exists on when and if a tongue-tie should be cut to help with breastfeeding.
  6. Some babies’ tongues may adapt and stretch over time, improving breastfeeding without surgery.
  7. Review of current evidence on the effectiveness of frenectomy for babies with tongue-tie and guidelines for using this procedure.

What to Ask Your Doctor

  1. What is a z-plasty and how does it differ from other procedures like frenectomy or frenuloplasty?
  2. How is a z-plasty performed and what is the recovery process like for the patient?
  3. What are the potential risks and complications associated with a z-plasty procedure?
  4. How effective is a z-plasty in treating tongue-tie compared to other procedures?
  5. Are there any specific factors that would make a patient a better candidate for a z-plasty over other procedures?
  6. What is the success rate of z-plasty in improving breastfeeding issues caused by tongue-tie?
  7. Are there any long-term effects or considerations to keep in mind after undergoing a z-plasty procedure?
  8. How many z-plasty procedures have you performed for tongue-tie, and what is your experience and success rate with this procedure?
  9. Are there any alternative treatments or therapies that could be considered before opting for a z-plasty?
  10. What follow-up care or monitoring is necessary after a z-plasty procedure for tongue-tie?

Reference

Authors: [No authors listed] Journal: Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2016 Jun 15. PMID: 27403491