2025 International journal of pedi…

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

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International journal of pediatric otorhinolaryngology Vol. 191 : 112280 • Apr 2025

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.

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