[Infant ankyloglossia: Current data, scientific controversy, and medico-legal issues. A critical review of the literature].

INTRODUCTION

Ankyloglossia is a congenital condition characterized by limited tongue mobility due to an abnormality of the lingual frenulum. Long considered benign, it is now the subject of growing interest, with an increase in diagnoses and neonatal frenotomies, amid controversy stemming from the heterogeneity of diagnostic criteria and the limited level of evidence regarding long-term benefits.

OBJECTIVE

The objective of this study is to critically analyze the embryological basis of ankyloglossia, its clinical implications, the indications for frenotomy, and the medico-legal issues associated with this procedure in infants.

MATERIALS AND METHOD: A critical narrative review of the international literature was conducted using major biomedical databases, including randomized trials, observational studies, meta-analyses, and institutional guidelines. Data analysis was performed using an integrative approach combining anatomy, pathophysiology, clinical findings, and ethical considerations.

RESULTS

The data suggest a short-term benefit of frenotomy, particularly regarding maternal pain and certain sucking parameters. However, evidence of a lasting effect on breastfeeding or the prevention of subsequent problems remains limited.

DISCUSSION: Interpretation of the results is limited by the heterogeneity of diagnostic criteria, variability in practices, and the small number of longitudinal studies. The increase in interventions raises a risk of overdiagnosis and overmedicalization, justifying an indication based on an objective functional impact and an approach consistent with evidence-based medicine.

CONCLUSION

Neonatal frenotomy may be beneficial in the short term for selected indications, but it should not be performed routinely or prophylactically.