Author Affiliations: Division of Pediatric Surgery, Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan, China (Yeh ML)

Corresponding Author: Ming-Lun Yeh, MD, Division of Pediatric Surgery, Department of Surgery, E-Da Hospital, 1, E-Da Road, Yan-Chao Shiang, Kaohsiung County, Taiwan 824, China (Tel: +886-7-6150011 ext 2975; Fax: +886-7-6150982; Email: ed103434@edah.org.tw)

Background: Tongue-tie is a common but often neglected condition. The indications and the techniques for its division are still controversial. In this report, I will present my personal experience and advocate early and aggressive treatment. 

Methods: Two different techniques are used to divide the tongue-tie at the outpatient clinic without anesthesia. For small infants, a parent sits opposite the doctor, with their knees in contact, the infant lies supine with his/her head towards the doctor. The tongue is lifted superiorly with the doctor's middle finger or middle and index fingers. The doctor uses the other hand to divide the tongue-tie with a pair of blunt-tipped scissors. In a cooperative child with teeth and relatively thin membrane, a sitting position is used. The tongue is elevated upward with a tongue depressor and the tongue-tie is released by a quick cut.

Results: From 1980 to 2006, about 2800 cases of tongue-tie were treated. Post-division minor bleeding in most of the cases was self-limited and always stopped spontaneously very quickly. Three patients who had recurrent tongue-tie underwent repeated division in the operating room under general anesthesia.

Conclusions: Division of tongue-tie is a simple, easy and safe procedure. It can be done as an outpatient procedure without anesthesia in almost all infants and some older children.

Key words: ankyloglossia; ankyloglossia inferior; tongue-tie

                   World J Pediatr 2008;4(2):106-108