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Ankyloglossia: Last three-years of outpatient care at a tertiary referral center.

Abstract

INTRODUCTION

Ankyloglossia is an oral anomaly characterized by a shortened, thickened lingual frenulum that may cause reduced tongue mobility. However, the diagnosis and management of this condition has long been a debated topic. Given the paucity of high level evidence, management can be frustrating for both families and clinicians. Our study aims to examine differences in the management of ankyloglossia and investigate influencing factors at a single tertiary pediatric referral center.

METHODS

A retrospective chart review was completed of children less than one year of age seen in the outpatient otolaryngology clinic. Billing records were searched for ICD-9 code 750.0 (ankyloglossia) between January 2, 2015 and October 9, 2017 and data extracted from the charts of those meeting inclusion criteria.

RESULTS

A total of 266 charts were reviewed that met the inclusion criteria during the study period. 100 (38%) were female with a mean age of 2.9 months. In the final multivariate regression model, children seen by providers in Group 1 (providers with high rates of frenotomies) had 4.4 times the odds of having a frenotomy as those seen by a provider in Group 2 (providers with low rates of frenotomies) (p < 0.001, 95%CI: 2.2, 8.9), and male children had 2.5 times the odds of having a frenotomy as female children (p = 0.002, 95%CI: 1.4, 4.5).

CONCLUSION

In this study we identify additional variables that may influence the decision to perform a frenotomy in children with ankyloglossia. The significant impact of clinician biases in the management of ankyloglossia suggests arbitrary differences in the way these patients are managed, highlighting the lack of consensus amongst otolaryngologists and the need for clear indications and diagnostic criteria.

Authors+Show Affiliations

University of Southern California Keck School of Medicine, 1975 Zonal Ave, Los Angeles, CA, 90033, USA. Electronic address: vletran@usc.edu.Children's Hospital Los Angeles Division of Otolaryngology - Head and Neck Surgery, 4650 Sunset Blvd. MS#58, Los Angeles, CA, 90027, USA. Electronic address: bosterbauer@chla.usc.edu.University of California Los Angeles David Geffen School of Medicine, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA. Electronic address: FBuen@mednet.ucla.edu.University of Southern California Keck School of Medicine, 1975 Zonal Ave, Los Angeles, CA, 90033, USA. Electronic address: Ronica.Yalamanchili@med.usc.edu.Children's Hospital Los Angeles Division of Otolaryngology - Head and Neck Surgery, 4650 Sunset Blvd. MS#58, Los Angeles, CA, 90027, USA. Electronic address: ggomez@chla.usc.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31352228

Citation

LeTran, Vivian, et al. "Ankyloglossia: Last Three-years of Outpatient Care at a Tertiary Referral Center." International Journal of Pediatric Otorhinolaryngology, vol. 126, 2019, p. 109599.
LeTran V, Osterbauer B, Buen F, et al. Ankyloglossia: Last three-years of outpatient care at a tertiary referral center. Int J Pediatr Otorhinolaryngol. 2019;126:109599.
LeTran, V., Osterbauer, B., Buen, F., Yalamanchili, R., & Gomez, G. (2019). Ankyloglossia: Last three-years of outpatient care at a tertiary referral center. International Journal of Pediatric Otorhinolaryngology, 126, p. 109599. doi:10.1016/j.ijporl.2019.109599.
LeTran V, et al. Ankyloglossia: Last Three-years of Outpatient Care at a Tertiary Referral Center. Int J Pediatr Otorhinolaryngol. 2019 Jul 22;126:109599. PubMed PMID: 31352228.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ankyloglossia: Last three-years of outpatient care at a tertiary referral center. AU - LeTran,Vivian, AU - Osterbauer,Beth, AU - Buen,Floyd, AU - Yalamanchili,Ronica, AU - Gomez,Gabriel, Y1 - 2019/07/22/ PY - 2019/06/14/received PY - 2019/07/15/revised PY - 2019/07/19/accepted PY - 2019/7/29/pubmed PY - 2019/7/29/medline PY - 2019/7/29/entrez KW - Ankyloglossia KW - Frenotomy KW - Pediatric SP - 109599 EP - 109599 JF - International journal of pediatric otorhinolaryngology JO - Int. J. Pediatr. Otorhinolaryngol. VL - 126 N2 - INTRODUCTION: Ankyloglossia is an oral anomaly characterized by a shortened, thickened lingual frenulum that may cause reduced tongue mobility. However, the diagnosis and management of this condition has long been a debated topic. Given the paucity of high level evidence, management can be frustrating for both families and clinicians. Our study aims to examine differences in the management of ankyloglossia and investigate influencing factors at a single tertiary pediatric referral center. METHODS: A retrospective chart review was completed of children less than one year of age seen in the outpatient otolaryngology clinic. Billing records were searched for ICD-9 code 750.0 (ankyloglossia) between January 2, 2015 and October 9, 2017 and data extracted from the charts of those meeting inclusion criteria. RESULTS: A total of 266 charts were reviewed that met the inclusion criteria during the study period. 100 (38%) were female with a mean age of 2.9 months. In the final multivariate regression model, children seen by providers in Group 1 (providers with high rates of frenotomies) had 4.4 times the odds of having a frenotomy as those seen by a provider in Group 2 (providers with low rates of frenotomies) (p < 0.001, 95%CI: 2.2, 8.9), and male children had 2.5 times the odds of having a frenotomy as female children (p = 0.002, 95%CI: 1.4, 4.5). CONCLUSION: In this study we identify additional variables that may influence the decision to perform a frenotomy in children with ankyloglossia. The significant impact of clinician biases in the management of ankyloglossia suggests arbitrary differences in the way these patients are managed, highlighting the lack of consensus amongst otolaryngologists and the need for clear indications and diagnostic criteria. SN - 1872-8464 UR - https://www.unboundmedicine.com/medline/citation/31352228/Ankyloglossia:_Last_three-years_of_outpatient_care_at_a_tertiary_referral_center L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-5876(19)30333-7 DB - PRIME DP - Unbound Medicine ER -