Impact of ankyloglossia on the language development of children

Objective: Ankyloglossia is a benign anomaly of the tongue which may cause functional limitation. Evidence regarding the impact ofankyloglossia on children’s language development is limited. We aimed to evaluate the language development of children born withankyloglossia.Patients and Methods: Children diagnosed with ankyloglossia were followed up prospectively. Demographic characteristics, degreeof ankyloglossia assessed by Hazelbaker score in infancy and its effects on breastfeeding were evaluated. Language development wastested by the Turkish version of the Test of Early Language Development-Third Edition and the Denver II Test at 3-5 years of age.Results: Out of 53 children diagnosed with ankyloglossia, 38 (71.7%) children had language development testing and were included intothe study. Significant ankyloglossia was detected in infancy in 10 of these children (26.3%). Median time of exclusively breastfeedingwas not different according to the severity of ankyloglossia. All children evaluated with Denver II Test were developmentally normalin all domains. Scores of Test of Early Language Development-Third Edition were not different between children with and withoutsignificant ankyloglossia.Conclusion: Long term language development of children with ankyloglossia was not adversely affected. Parents should beappropriately informed and efforts must be paid to prevent unnecessary surgical interventions concerning language delay.

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  • Lalakea ML, Messner AH. Ankyloglossia: does it matter? Pediatr Clin North Am 2003; 50: 381-97. doi: 10.1016/s0031-3955(03)00029-4.
  • Suter VG, Bornstein MM. Ankyloglossia: facts and myths in diagnosis and treatment. J Periodontol 2009; 80: 1204-19. doi: 10.1902/jop.2009.090086.
  • Forlenza GP, Paradise Black NM, McNamara EG, Sullivan SE. Ankyloglossia, exclusive breastfeeding, and failure to thrive. Pediatrics 2010; 125: e1500-4. doi: 10.1542/peds.2009-2101.
  • Messner AH, Lalakea ML. Ankyloglossia: controversies in management. Int J Pediatr Otorhinolaryngol 2000; 54: 123-31. doi: 10.1016/s0165-5876(00)00359-1.
  • Walsh J, Tunkel D. Diagnosis and treatment of ankyloglossia in newborns and infants: A review. JAMA Otolaryngol Head Neck Surg 2017; 143: 1032-9. doi: 10.1001/jamaoto.2017.0948.
  • Francis DO, Krishnaswami S, McPheeters M. Treatment of ankyloglossia and breastfeeding outcomes: a systematic review. Pediatrics 2015; 135: e1458-66. doi: 10.1542/peds.2015-0658.
  • Chinnadurai S, Francis DO, Epstein RA, Morad A, Kohanim S, McPheeters M. Treatment of ankyloglossia for reasons other than breastfeeding: a systematic review. Pediatrics 2015; 135: e1467-74. doi: 10.1542/peds.2015-0660.
  • Walls A, Pierce M, Wang H, Steehler A, Steehler M, Harley EH Jr. Parental perception of speech and tongue mobility in three-year olds after neonatal frenotomy. Int J Pediatr Otorhinolaryngol 2014; 78: 128-31. doi: 10.1016/j.ijporl.2013.11.006.
  • Webb AN, Hao W, Hong P. The effect of tongue-tie division on breastfeeding and speech articulation: a systematic review. Int J Pediatr Otorhinolaryngol 2013; 77: 635-46. doi: 10.1016/j.ijporl.2013.03.008.
  • Daggumati S, Cohn JE, Brennan MJ, Evarts M, McKinnon BJ, Terk AR. Speech and language outcomes in patients with ankyloglossia undergoing frenulectomy: A retrospective pilot study. OTO Open 2019; 3: 2473974X19826943. doi: 10.1177/2473974X19826943.
  • Hazelbaker AK. The Assessment Tool for Lingual Frenulum Function (ATLFF): use in a lactation consultant private practise. Pasadena California, Pacific Oaks College, Thesis, 1993.
  • Anlar B, Yalaz K. Denver II Gelişimsel Tarama Testi Türk Çocuklarına Uyarlanması ve Standardizasyonu El Kitabı. Ankara: Meteksan Matbaası; 1996.
  • Hresko WP, Reid DK, Hammill DD. The Test of Early Language Development 3.3. Austin, TX: PRO-ED; 1999.
  • Topbas S, Güven S. Türkçe Erken Dil Gelişim Testi TEDİL-3. (Adaptation of Test of Early Language Development-TELD 3 to Turkish). Ankara:Detay Yayıncılık; 2013.
  • Wallace AF. Tongue tie. Lancet 1963; 2: 377-8. doi: 10.1016/S0140-6736(63)93057-5.
  • McEnery ET, Gaines FP. Tongue-tie in infants and children. J Pediatr 1941; 18: 252-5.
  • Horton CE, Crawford HH, Adamson JE, Ashbell TS. Tongue-tie. Cleft Palate J 1969; 6: 8-23.
  • Messner AH, Lalakea ML. The effect of ankyloglossia on speech in children. Otolaryngol Head Neck Surg 2002; 127: 539-45. doi: 10.1067/mhn.2002.129731.
  • Messner AH, Lalakea ML, Aby J, Macmahon J, Bair E. Ankyloglossia: incidence and associated feeding difficulties. Arch Otolaryngol Head Neck Surg 2000; 126: 36-9. doi: 10.1001/archotol.126.1.36.
  • Muldoon K, Gallagher L, McGuinness D, Smith V. Effect of frenotomy on breastfeeding variables in infants with ankyloglossia (tongue-tie): a prospective before and after cohort study. BMC Pregnancy Childbirth 2017; 17: 373. doi: 10.1186/s12884-017-1561-8.
  • Klockars T, Pitkäranta A. Pediatric tongue-tie division: indications, techniques and patient satisfaction. Int J Pediatr Otorhinolaryngol 2009; 73: 1399-401. doi: 10.1016/j.ijporl.2009.07.004.
  • Daggumati S, Cohn JE, Brennan MJ, Evarts M, McKinnon BJ, Terk AR. Caregiver perception of speech quality in patients with ankyloglossia: Comparison between surgery and non-treatment. Int J Pediatr Otorhinolaryngol 2019; 119: 70-4. doi: 10.1016/j.ijporl.2019.01.019.
  • Heller J, Gabbay J, O'Hara C, Heller M, Bradley JP. Improved ankyloglossia correction with four-flap Z-frenuloplasty. Ann Plast Surg 2005; 54: 623-8. doi: 10.1097/01.sap.0000157917.91853.be.
  • Ito Y, Shimizu T, Nakamura T, Takatama C. Effectiveness of tongue-tie division for speech disorder in children. Pediatr Int 2015; 57: 222-6. doi: 10.1111/ped.12474.
  • Dollberg S, Manor Y, Makai E, Botzer E. Evaluation of speech intelligibility in children with tongue-tie. Acta Paediatr 2011; 100:he125-7. doi: 10.1111/j.1651-2227.2011.02265.x.
  • Salt H, Claessen M, Johnston T, Smart S. Speech production in young children with tongue-tie. Int J Pediatr Otorhinolaryngol 2020;134:110035. doi: 10.1016/j.ijporl.2020.110035.
  • Walsh J, Links A, Boss E, Tunkel D. Ankyloglossia and lingual frenotomy: National trends in inpatient diagnosis and management in the United States, 1997-2012. Otolaryngol Head Neck Surg 2017; 156: 735-40. doi: 10.1177/0194599817690135.
  • Joseph KS, Kinniburgh B, Metcalfe A, Razaz N, Sabr Y, Lisonkova S. Temporal trends in ankyloglossia and frenotomy in British Columbia, Canada, 2004-2013: a population-based study. CMAJ Open 2016; 4: E33-40. doi: 10.9778/cmajo.20150063.
  • Lisonek M, Liu S, Dzakpasu S, Moore AM, Joseph KS; Canadian Perinatal Surveillance System (Public Health Agency of Canada). Changes in the incidence and surgical treatment of ankyloglossia in Canada. Paediatr Child Health 2017; 22: 382-86. doi: 10.1093/pch/pxx112.
  • O'Shea JE, Foster JP, O'Donnell CP, et al. Frenotomy for tongue-tie in newborn infants. Cochrane Database Syst Rev 2017; 3: CD011065. doi: 10.1002/14651858.CD011065.pub2.
  • World Health Organization. Exclusive breastfeeding for six months best for babies everywhere https://www.who.int/mediacentre/news/statements/2011/breastfeeding_20110115/en/ accessed in July 8th, 2020.
  • Dixon B, Gray J, Elliot N, Shand B, Lynn A. A multifaceted programme to reduce the rate of tongue-tie release surgery in newborn infants: Observational study. Int J Pediatr Otorhinolaryngol 2018; 113: 156-63. doi: 10.1016/j.ijporl.2018.07.045.