A COMPREHENSIVE APPROACH TO THE TREATMENT OF ANKYLOGLOSSIA IN NEWBORNS

Recent epidemiological data from Ukraine demonstrate persistently high prevalence rates of ankyloglossia among neonates. In breastfed infants, a shortened lingual frenulum may contribute to maternal nipple trauma and compromise effective milk extraction, potentially leading to premature breastfeeding discontinuation. The recommended management involves timely surgical intervention through frenulotomy, a minimally invasive procedure ideally performed during the early neonatal period when the frenulum presents as a thin membranous structure. Immediate postprocedural breastfeeding facilitates proper latch establishment, while early intervention helps prevent development of maladaptive sucking patterns and minimizes long-term complications. The aim of the study is to develop comprehensive clinical guidelines for the diagnosis and treatment of congenital ankyloglossia in neonatal populations. Material and methods. A prospective clinical study was conducted at the Perinatal Center of Mykolaiv Regional Clinical Hospital throughout 2024, involving 265 neonatal patients. Diagnostic assessments were performed by a multidisciplinary team including a neonatologist, an oral and maxillofacial surgeon, and a breastfeeding consultant. Standardized examination protocols were employed to evaluate frenulum morphology and functional impact. Results. Among 265 examined neonates, 38 cases of congenital ankyloglossia were identified, representing a prevalence rate of 14.34%. The cohort demonstrated three distinct anatomical variations. Type II ankyloglossia, characterized by a thin, translucent frenulum with anterior tongue attachment, was observed in 16 infants (42.10% of affected cases). Type III presentation, featuring a dense fibrous band with significant mobility restriction, was documented in 12 newborns (31.58%). The Type I variant, comprising a short membranous attachment, was identified in 10 cases (26.32%). In breastfed infants, an abnormally short lingual frenulum represents a significant pathological factor that may cause maternal nipple discomfort and traumatic injury, while simultaneously compromising the infant's ability to effectively extract breast milk. These combined factors frequently contribute to premature discontinuation of breastfeeding. For neonates presenting with a thin, shortened frenulum that demonstrably impairs sucking function and results in inadequate weight gain, immediate frenulotomy−involving a precise transverse incision of the mucosal fold−represents the intervention of choice. This procedure is optimally performed within the initial postnatal days, though may be appropriately deferred to subsequent weeks or , provided the frenulum is a mucosal fold. The intervention is routinely conducted in either maternity ward settings or outpatient clinics, requiring no suturing due to the minimal nature of the surgical site. In cases where examination reveals a thickened, fibrous frenular band, more comprehensive surgical correction through frenuloplasty becomes necessary, with such procedures typically scheduled during early infancy to ensure optimal functional outcomes. Conclusions. The study revealed a substantial prevalence of lingual frenulum developmental anomalies among newborns, with these anatomical variations demonstrating clear correlation with impaired breastfeeding establishment. These findings demonstrate that optimal management requires a comprehensive interdisciplinary approach to diagnosis and treatment for complete medical and social rehabilitation of affected infants. Early detection through professional examination, combined with accurate multidisciplinary evaluation, enables timely intervention that directly facilitates successful breastfeeding, proper weight gain, and supports normal infant development−ultimately improving quality of life outcomes. Of particular importance are targeted educational initiatives focused on maternal populations, with special consideration given to primiparous mothers, regarding early signs of feeding difficulties and available interventions.