{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T20:04:08Z","timestamp":1791057848411,"version":"4.1.0"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ear Nose Throat J"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Recent studies redefine the infant lingual frenulum as a dynamic structure formed by oral mucosa, floor-of-mouth fascia, and genioglossus muscle, rather than a mucosal band. Many existing studies rely on simple sublingual mucosa \u2018snip\u2019 techniques, which have led to high revision rates (8-29%). We review a protocol for infant ankyloglossia management aligned with current expert recommendations to achieve optimum frenulum release.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective case series from a single academic pediatric otolaryngology practice (2002-2023), infants with clinically significant ankyloglossia underwent frenulotomy with complete division of the lingual frenulum to the sublingual fold. If release was functionally incomplete, central dissection continued to include floor of mouth fascia and genioglossus fibers. Demographics, procedural characteristics, mother-infant dyad satisfaction, and complications were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1,367 infants evaluated, 585 underwent in-office frenulotomy. Mean age was 27.66 days (SD = 31.08), and 62.22% were male. Anterior division was performed in 91.45% of cases, while 8.55% required posterior release. Successful division, defined as improved tongue mobility and\/or feeding, was achieved in 98.97% of cases. Five infants (0.85%) required revision surgery. One child required silver nitrate cautery for bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This microscopically guided approach to infant lingual frenula release demonstrates excellent results with few complications in the office setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>4 \u2013 Case Series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/01455613261486890","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:18:01Z","timestamp":1788308281000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["A Protocol for In-Office Management of Infant Ankyloglossia"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1538-6187","authenticated-orcid":false,"given":"Robert","family":"Duncheskie","sequence":"first","affiliation":[{"name":"Lewis Katz School of Medicine at Temple University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5977-1796","authenticated-orcid":false,"given":"Glenn","family":"Isaacson","sequence":"additional","affiliation":[{"name":"Lewis Katz School of Medicine at Temple University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2024-067605"},{"issue":"2","key":"e_1_3_7_3_2","first-page":"101","article-title":"Lingual frenectomy: functional evaluation and new therapeutical approach","volume":"13","author":"Olivi G","year":"2012","unstructured":"Olivi G, Signore A, Olivi M, Genovese MD. Lingual frenectomy: functional evaluation and new therapeutical approach. Eur J Paediatr Dent. 2012;13(2):101-106.","journal-title":"Eur J Paediatr Dent"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ca.23410"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820915457"},{"issue":"6","key":"e_1_3_7_6_2","first-page":"1027","article-title":"Prevalence, diagnosis, and treatment of ankyloglossia: methodologic review","volume":"53","author":"Segal LM","year":"2007","unstructured":"Segal LM, Stephenson R, Dawes M, Feldman P. Prevalence, diagnosis, and treatment of ankyloglossia: methodologic review. 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In: American Academy of Pediatric Dentistry. 2025:80-85. https:\/\/www.aapd.org\/globalassets\/media\/policies_guidelines\/p_mgmt_frenulum.pdf. accessed February 14, 2026."},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2021.29179.ylf"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820937299"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199905000-00030"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000007788"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816636102"},{"issue":"6","key":"e_1_3_7_25_2","first-page":"CD006275","article-title":"Non-pharmacological management of infant and young child procedural pain","volume":"6","author":"Pillai Riddell RR","year":"2023","unstructured":"Pillai Riddell RR, Bucsea O, Shiff I, et al. Non-pharmacological management of infant and young child procedural pain. 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