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Dell'Olio F, Baldassarre ME, Russo FG, Schettini F, Siciliani RA, Mezzapesa PP, Tempesta A, Laforgia N, Favia G, Limongelli L. Lingual laser frenotomy in newborns with ankyloglossia: a prospective cohort study. Ital J Pediatr 2022; 48:163. [PMID: 36064609 PMCID: PMC9446865 DOI: 10.1186/s13052-022-01357-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/27/2022] [Indexed: 12/04/2022] Open
Abstract
Background The study aims to describe the lingual laser frenotomy perioperative protocol for newborns with ankyloglossia with or without breastfeeding difficulties developed by Odontostomatology and Neonatology and Neonatal Intensive Care Units of the Aldo Moro University of Bari. Methods Authors carried out a prospective observational cohort study. Newborns with ankyloglossia (classified by using both Coryllos’ and Hazelbaker’s criteria) with or without difficult breastfeeding (according to Infant Breastfeeding Assessment Tool) underwent diode laser frenotomy (800 ± 10 nm; 5 W; continuous wave mode; contact technique; under topical anesthesia) and follow-up visits after seven and thirty days postoperatively. The authors analyzed as main outcomes the perioperative pain intensity measured by the C.R.I.E.S. scale, the occurrence of complications and quality of healing, the quality of breastfeeding, newborn’s postoperative weight gain, maternal nipple pain, and the presence of lesions as secondary outcomes. Results Fifty-six newborns were included in the current study. Intraoperative mean pain intensity was 5.7 ± 0.5 points, resolved within thirty postoperative minutes. Observed complications were mild punctuating bleeding, carbonization of the irradiated site, and transitory restlessness. All wounds were completely healed within the thirtieth postoperative day. During follow-up, a significant breastfeeding improvement was evident with satisfactory newborns’ weight gain and a significant reduction of nipple pain and lesions (p < .05). Conclusion Our lingual laser frenotomy protocol provided significant breastfeeding improvement in the mother-newborn dyads with low intraoperative pain and no significant complications.
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Affiliation(s)
- Fabio Dell'Olio
- Complex Unit of Odontostomatology, University of Bari Aldo Moro, Bari, Italy. .,Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy.
| | - Maria Elisabetta Baldassarre
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy.,Neonatology and Neonatal Intensive Care Unit (NICU), University of Bari Aldo Moro, Bari, Italy
| | - Fabio Giovanni Russo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy.,Neonatology and Neonatal Intensive Care Unit (NICU), University of Bari Aldo Moro, Bari, Italy
| | - Federico Schettini
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy.,Neonatology and Neonatal Intensive Care Unit (NICU), University of Bari Aldo Moro, Bari, Italy
| | - Rosaria Arianna Siciliani
- Complex Unit of Odontostomatology, University of Bari Aldo Moro, Bari, Italy.,Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Pietro Paolo Mezzapesa
- Complex Unit of Odontostomatology, University of Bari Aldo Moro, Bari, Italy.,Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Angela Tempesta
- Complex Unit of Odontostomatology, University of Bari Aldo Moro, Bari, Italy.,Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Nicola Laforgia
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy.,Neonatology and Neonatal Intensive Care Unit (NICU), University of Bari Aldo Moro, Bari, Italy
| | - Gianfranco Favia
- Complex Unit of Odontostomatology, University of Bari Aldo Moro, Bari, Italy.,Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Luisa Limongelli
- Complex Unit of Odontostomatology, University of Bari Aldo Moro, Bari, Italy.,Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
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Campbell-Yeo M, Eriksson M, Benoit B. Assessment and Management of Pain in Preterm Infants: A Practice Update. CHILDREN (BASEL, SWITZERLAND) 2022; 9:244. [PMID: 35204964 PMCID: PMC8869922 DOI: 10.3390/children9020244] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/20/2022] [Accepted: 02/02/2022] [Indexed: 12/11/2022]
Abstract
Infants born preterm are at a high risk for repeated pain exposure in early life. Despite valid tools to assess pain in non-verbal infants and effective interventions to reduce pain associated with medical procedures required as part of their care, many infants receive little to no pain-relieving interventions. Moreover, parents remain significantly underutilized in provision of pain-relieving interventions, despite the known benefit of their involvement. This narrative review provides an overview of the consequences of early exposure to untreated pain in preterm infants, recommendations for a standardized approach to pain assessment in preterm infants, effectiveness of non-pharmacologic and pharmacologic pain-relieving interventions, and suggestions for greater active engagement of parents in the pain care for their preterm infant.
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Affiliation(s)
- Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Pediatrics, Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada
- IWK Health, Halifax, NS B3K 6R8, Canada
| | - Mats Eriksson
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden;
| | - Britney Benoit
- Rankin School of Nursing, St. Francis Xavier University, Antigonish, NS B2G 2N5, Canada;
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How to Treat a Tongue-tie: An Evidence-based Algorithm of Care. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3336. [PMID: 33564576 PMCID: PMC7859174 DOI: 10.1097/gox.0000000000003336] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/21/2020] [Indexed: 11/27/2022]
Abstract
Ankyloglossia, or tongue-tie, is characterized by a short or thickened lingual frenulum; this can be associated with impaired breastfeeding, speech, and dentofacial growth. The indications for performing frenotomy, frenuloplasty, or other operative interventions are unclear.
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