Outcomes of stretching exercises after lingual frenotomy in infants: A prospective, interventional study

Abstract

Objective

To evaluate the safety and efficacy of stretching exercises after frenotomy for ankyloglossia.

Study design

Prospective cohort study.

Setting

Single academic tertiary care hospital.

Methods

Subjects with ankyloglossia were enrolled from 4/5/2021–4/5/2023. All patients underwent in-office frenotomy using scissors. Patients enrolled from 4/5/2021–10/5/2021 and 4/6/2022–4/5/2023 were assigned to the stretching group; those enrolled from 10/6/2021–4/5/2022 were assigned to the non-stretching group. Caregivers of patients in the stretching group were instructed on how to perform stretching exercises. All patients returned to clinic after one month for evaluation. Chart review was performed and demographic and outcomes data were collected.

Results

Eighty-eight patients were included. There were 25 patients in the non-stretching group and 63 in the stretching group; however, only 36 were adherent to stretching exercises and 27 were non-adherent. The average age of participants was 50.0 ± 45.5 days; 59.0 % were male. Preoperatively, all but one patient had breastfeeding difficulties. For the stretching adherent, stretching non-adherent, and non-stretching groups, there were persistent feeding difficulties present in 0 % (n = 0), 14.8 % (n = 4), and 16 % (n = 4), respectively (p = 0.024). Recurrent ankyloglossia was present in 5.6 % (n = 2), 40.7 % (n = 11), and 16 % (n = 4) of patients in the stretching adherent, stretching non-adherent, and non-stretching groups, respectively (p = 0.003). A revision procedure was required in 5.6 % (n = 2), 37.0 % (n = 10), and 32 % (n = 8) of those in the stretching adherent, stretching non-adherent, and non-stretching groups, respectively (0.005).

Conclusion

Stretching exercises improved patient-reported feeding difficulties, the development of recurrent frenulum, scarring, and need for revision procedure. Postoperative regimen adherence may be challenging for caregivers.