Office frenotomy for neonates: resolving dysphagia, parental satisfaction and cost-effectiveness.

Abstract

Objective: To determine parental satisfaction and cost-effectiveness of having a frenotomy performed in the office setting versus in the operating room under general anesthesia.

Method: After obtaining IRB approval at The Children's Hospital of Philadelphia (CHOP), we performed a retrospective chart review of patients having a frenotomy in the office between 2003-2008. 55 patients met the criteria and 25 were consented and their parents interviewed.

Conclusion: All participants reported an improvement in feeding within one day and up to two weeks following the procedure. Parents also reported being somewhat satisfied to very satisfied with having the frenotomy performed in the office versus under general anesthesia. There were no complications reported. Performing the frenotomy in the office provided patients with satisfaction as well as cost savings. The surgical fee for a frenotomy in the office is $850 and is the same as if the procedure is performed in the operating room. Performing a frenotomy under general anesthesia includes extra cost which consists of an anesthesia fee of $500-$900 and hospital charges ranging from $500-$8,000. Performing the frenotomy in the office on our 25 patients has resulted in a cost savings of more than $240,000 and the avoidance of general anesthesia in the first few weeks of life. Office frenotomy should be considered in children with ankyloglossia who present with difficulty nursing in the first week of life.