Evidence map›Paper›PMID 39529230›Full record

SynthesisThe Annals of otology, rhinology, and laryngology2025

The Impact of Frenotomy on Gastroesophageal Reflux in Pediatric Ankyloglossia: A Systematic Review.

Ashaka Patel, Katrina Cirone, Sami Khoury, Edward Madou, Agnieszka Dzioba, Dhandapani Ashok, Julie E Strychowsky, M Elise Graham

Abstract readSystematic Review
In one paragraph

Synthesis in The Annals of otology, rhinology, and laryngology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ashaka PatelSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Katrina CironeSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.ORCID 0000-0001-5439-228X
Sami KhouryDepartment of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, London, ON, Canada.ORCID 0000-0002-7174-116X
Edward MadouDepartment of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, London, ON, Canada.
Agnieszka DziobaSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.ORCID 0000-0002-7609-5988
Dhandapani AshokDivision of Pediatric Gastroenterology, Department of Pediatrics, London Health Sciences Centre, London, ON, Canada.
Julie E StrychowskySchulich School of Medicine and Dentistry, Western University, London, ON, Canada.
M Elise GrahamSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.ORCID 0000-0001-7159-2953

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis systematic review was conducted to assess if there are changes in gastroesophageal reflux (GER) outcomes after frenotomy in infants with ankyloglossia.

methodsSystematic Review. CINAHL, Cochrane, EMBASE, Pubmed, and Scopus were searched from inception to May 20, 2023. Inclusion criteria consisted of all study designs, infants ≤12 months of age with ankyloglossia, and use of quantitative GER measures (esophageal pH manometry (pH) or multi-channel intraluminal impedance (MII), and/or patient-reported symptom scores) pre- and post-frenotomy. Quality assessment and data extraction were performed in duplicate.

resultsOf 37 articles screened, 7 met inclusion criteria (6 prospective cohort studies and 1 RCT). No studies utilized objective measures to quantify reflux, that is MII or pH. The number of infants with ankyloglossia ranged from 47 to 237 (mean age of 4.4-8.3 weeks). Qualitative analysis included all 7 studies which used the GIGER, I-GERQ-R, and GSQ-I scales to assess GER. Parent-reported GER scores decreased post-frenotomy. However, the lack of control groups in the prospective cohort studies precludes conclusive findings that changes are related to frenotomy. Meta-analysis was not possible due to the high risk of bias from limited sample sizes, poor methodology, and lack of adequate control groups.

conclusionLimited work has been conducted on the relationship between frenotomy and GER in infants with ankyloglossia. The lack of high-quality studies precludes definitive conclusions, as GER symptoms are known to improve spontaneously with time. Future RCT studies are warranted to further elucidate the effect of frenotomy on symptoms of GER in infants with ankyloglossia. LEVEL OF EVIDENCE: III.

Indexed as

AnkyloglossiaGastroesophageal RefluxLingual FrenumEsophageal pH MonitoringHumansInfantInfant, Newbornankyloglossiafrenotomygastroesophageal reflux diseaseGERDI-GERQ-R

Identifiers

PMID39529230
PMCPMC11806641

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.