Avaliação dos efeitos do laser diodo de alta potência e do eletrocautério nas cirurgias de frenectomia lingual em lactentes- estudo clínico controlado randomizado cego

Abstract

Ankyloglossia is characterized by an abnormally short, thick or thin lingual frenulum, that can restrict tongue movements and negatively interfere with breastfeeding, decreasing the newborn’s ability to adequately suck and breastfeeding. The management of a newborn with a positive test for ankyloglossia must always consider if this condition interferes with breastfeeding and, for this reason, the importance of evaluating breastfeeding as a routine procedure. In the difficulty of breastfeeding to ankyloglossia, lingual frenectomy is recommended to release the lingual frenulum allowing the tongue to move and can be the first step in solving the problem. The objective of this study was to evaluate the release of the lingual frenulum, by means of lingual frenectomy, in newborns aged 0 to 3 months, who had ankyloglossia with surgical indication, performed by thermal instruments such as electrocautery and high-level diode laser. The study evaluated 57 participants, randomly divides into 2 groups, 23 from the electrocautery group and 34 from laser group. The condition of tongue movement was diagnosed through clinical evaluation and Bristol protocol (BTAT) suggested by the Ministry of Health of Brazil, in the moments before and 15 days after the surgical procedures, as well as the application of the EVA pain test for the nursing mothers simultaneously. Through the clinical examination and standardized photographs, it was possible to assess the condition of the tongue and observe the breastfeeding according to the UNICEF indication. There is still no consensus on the indications or surgical method for repair of ankyloglossia. Both surgical techniques used in this study were safe, effective, caused little bleeding a few postoperative complications. It is recommended to make the diagnosis and treatment of ankyloglossia in a transdisciplinary way to offer the best result to the patient, and it is essential that the surgeon has skill and in-depth knowledge of the surgical technique and the equipment used, in order to avoid accidents and complications in a region of noble structures. The use of high-level diode laser indicated for lingual frenectomy in the manner described in this study did not have the expected result, presenting postoperative healing with a high chance of relapse.