Ankyloglossia in Children, a Cause of Obstructive Sleep Apnoea: Case Report of Paediatric Ankyloglossia and Sleep Apnoea: DISE Resolves the Mystery

Abstract

Tongue mobility is an obstructive sleep apnoea (OSA) marker and myofunctional therapy (MFT) target. For this reason, all paediatric patients with sleep-disordered breathing should require a combined functional assessment from an ear, nose, and throat (ENT) specialist and a phonoaudiologist to confirm or rule out the presence of ankyloglossia. To our knowledge, this is the first case of a 13-year-old girl diagnosed with severe OSA and a significant decrease of 94% in her apnoea index (AI), requiring frenotomy with an immediate postoperative change in the tongue position. A drug-induced sleep endoscopy (DISE) was performed before and immediately postfrenotomy, and the anatomical changes provoked by this surgery during sleep were confirmed for the first time.

Keywords: ankyloglossia; drug-induced sleep endoscopy; frenulectomy; sleep apnoea.

Figure 1

Ankyloglossia associated with teeth malposition.

Figure 2

The surgical protocol used to code the DISE results according to the VOTE scale is as described in reference. ^a Degree of obstruction has one number for each structure: 0, Noobstruction (no vibration); 1, Partial obstruction (vibration); 2, Complete obstruction (collapse); X, Not visualized. ^b Oropharynx obstruction can be distinguished as related solely to thetonsils or including the lateral walls, with or without a tonsillarcomponent. ^c Configuration noted for structures with degree of obstructiongreater than.