Ankyloglossia in newborn- Case report

Abstract

The lingual frenulum is the structure that attaches the tongue to the floor of the mouth. If the lingual frenulum is short, it results in feeding difficulties, pain in mother’s nipple, speech disorientation and also articulation problem. Anterior ankyloglossia is easily detectable, but posterior ankyloglossia doesn’t have the usual appearance of traditional anterior ankyloglossia. It is widely unknown and under diagnosed entity. Hence both the types of ankyloglossia interfere with breastfeeding causing maternal pain.  National Health Service and Canadian paediatric society recommend treatment if ankyloglossia interfere with breast feeding. The limitation in lingual mobility in newborns can compromise sucking and latching on to the breast. Tongue tie is usually seen in newborns and also in children. In newborn, sometimes it spontaneously regresses. In children, it leads to speech abnormality and language developmental defect. Here we present a case of newborn type I Ankyloglossia. The incidence of ankyloglossia is increasing, a probable cause due to environmental pollutants. Ankyloglossia is of 2 types, Anterior Ankyloglossia and Posterior Ankyloglossia. We can treat this condition medically by simple physical exercises or surgically by frenotomy. Complications of frenotomy are bleeding, infection, scarring. Damage may occur to the tongue or salivary gland. Sometimes, the wound heals with scar formation causing fibrosis and the frenulum may reattach to the base of the tongue. Frenuloplasty is needed when a more robust correction is needed or if the frenulum is too thick for frenotomy. Frenuloplasty must be done under general anaesthesia and the risk of anaesthesia should be weighed against the benefit from surgery.