Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 Sep;282(9):4867-4875.
doi: 10.1007/s00405-025-09534-2. Epub 2025 Jul 5.

Postural and cervical proprioceptive implications in adult humans with ankyloglossia: an observational study

Alessandro Micarelli  1 , Martina Arena  2 , Adriano Di Benedetto  3 , Fabio Scarpa  2 , Riccardo Xavier Micarelli  2 , Marco Alessandrini  4
Affiliations
Observational Study

Postural and cervical proprioceptive implications in adult humans with ankyloglossia: an observational study

Alessandro Micarelli et al. Eur Arch Otorhinolaryngol. 2025 Sep.

Abstract

Purpose: To evaluate how tongue tie could impact on neck performance and posturographic testing as well as on subjective consequences on dizziness and jaw functionality, when comparing adult participants with different degrees of ankyloglossia (ANK) according to Kotlow classification with a group of healthy subjects, serving as control group (CG).

Methods: ANK and CG participants have been studied by means of quantitative tongue evaluations (including Mouth Opening with Tongue Tip to incisive papilla, MOTTIP, and Maximal Intercisal Mouth Opening, MIO), posturography testing, cervical range of motion (CROM), cervical relocation tests (CRT) and subjective testing (Dizziness Handicap Inventory, DHI, and Jaw Functional Limitations Scale 20, JFLS-20).

Results: 96 ANK participants demontrated to have significant (p < 0.01) higher values in length and in area parameters when compared with 98 CG participants. A significant increase in power spectra values was found within the middle-/high-frequency interval ANK when compared to CG. ANK participants demonstrated significant reduced cervical spine mobility and higher values in all CRT positions as well as significant higher values along DHI and JFLS-20 sub-item and total score. Multiple significant (p < 0.05) correlations were found in ANK participants between tongue measures, cervical mobility, postural parameters and subjective testing.

Conclusion: The present study for the first time demonstrated that the tongue tie may actively partecipate in postural derangement possibly mediated by a wide span of anatomical and functional sequelae in the cervical spine, with consequences not only at jaw functional limitations but also at perceived dizziness level.

Keywords: Ankyloglossia; Cervical proprioception; Cervical range of motion; Dizziness; Posturography; Tongue tie.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethical approval: The study was approved by the “Tor Vergata” University Hospital Institutional Review Board (approval number 35/17 on April 13th, 2017) and it adhered to the principles of the Declaration of Helsinki. Informed consent: Informed consent was obtained from all individual participants included in the study. Conflict of interest: The authors declare that they have no conflict of interest.

References

    1. Ferrés-Amat E, Pastor-Vera T, Ferrés-Amat E, Mareque-Bueno J, Prats-Armengol J, Ferrés-Padró E (2016) Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol. Med Oral Patol Oral Cir Bucal 21(1):e39–47. https://doi.org/10.4317/medoral.20736 - DOI - PubMed
    1. Segal LM, Stephenson R, Dawes M, Feldman P (2007) Prevalence, diagnosis, and treatment of ankyloglossia: methodologic review. Can Fam Physician 53(6):1027–1033 - PubMed - PMC
    1. Cruz PV, Souza-Oliveira AC, Notaro SQ, Occhi-Alexandre IGP, Maia RM, De Luca Canto G, Bendo CB, Martins CC (2022) Prevalence of ankyloglossia according to different assessment tools: A meta-analysis. J Am Dent Assoc 153(11):1026–1040e1031. https://doi.org/10.1016/j.adaj.2022.07.011 - DOI - PubMed
    1. Arena M, Micarelli A, Guzzo F, Misici I, Jamshir D, Micarelli B, Castaldo A, di Benedetto A, Alessandrini M (2022) Outcomes of tongue-tie release by means of tongue and frenulum assessment tools: a scoping review on non-infants. Acta Otorhinolaryngol Ital 42(6):492–501. https://doi.org/10.14639/0392-100x-n2211 - DOI - PubMed - PMC
    1. Chinnadurai S, Francis DO, Epstein RA, Morad A, Kohanim S, McPheeters M (2015) Treatment of ankyloglossia for reasons other than breastfeeding: a systematic review. Pediatrics 135(6):e1467–1474. https://doi.org/10.1542/peds.2015-0660 - DOI - PubMed

Publication types

LinkOut - more resources