400 Section IX ■ Miscellaneous Procedures

discomfort, improved latch, stronger suckling, and

absence of the clicking sounds frequently produced by

the tongue-tied infant while breast-feeding

(6,7,18,19,21–28).

If no improvement is noted, it is important to work

with mother and baby in suck training and continue

frequent re-evaluation.

12. Antibiotic therapy is not required.

13. Postoperatively, a white fibrin clot may form.

Reassure parents that this is not a sign of infection.

14. Arrange follow-up in 1 to 2 weeks to check healing of

the incision.

J. Complications (2,6,13,18,19,24,26)

1. Extremely rare when performed by a practitioner familiar and comfortable with the procedure

a. Excessive bleeding virtually never occurs unless

deep lingual arteries and/or veins are severed.

b. Infection: Extremely rare

c. Damage to tongue: Extremely rare

d. Damage to submandibular ducts: Extremely rare

e. Recurrent ankyloglossia due to excessive scarring

(1) Generally less severe than original presentation

(2) Often amenable to revision surgery

f. Glossoptosis (tongue swallowing) due to excessive

tongue mobility

Theoretical concern—has never been reported

in modern literature.

Acknowledgement

Photographs and assistance with procedural information on

posterior tongue tie courtesy of Evelyn Jain, BA, BSc, MD,

FCFP, Clinical Assistant Professor, Department of Family

Medicine, University of Calgary, Calgary, Alberta, Canada.

Fig. 57.8. Completed frenotomy of posterior tongue tie with

open diamond evident. (Photograph courtesy of Evelyn Jain BA,

BSc, MD, FCFP.)

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