Table 1

Point system for assessing quality of the 6 studies that addressed the effectiveness of frenotomy for treatment of ankyloglossia

STUDY POPULATION
Patient selection
 0—Not described
 1—Any reason given
 2—Only exclusion criteria given
 3—Both inclusion and exclusion criteria given
Study design
 1—Case report
 2—Case series
 3—Cohort study
 4—Retrospective case-control study
 5—Prospective case-control study
 6—Randomized controlled trial
Sample size
 1—<100
 2—100–1000
 3—>1000
Number of patients with ankyloglossia
 1—<20
 2—20–100
 3—>100
Number of patients having frenotomy
 0—0
 1—<10
 2—10–100
  3—>100
Patient characteristics at baseline (1 point per criterion)

  • Age

  • Sex

  • Severity of tongue-tie

  • Severity of nipple pain

  • Severity of nipple trauma

  • Infant well-being (weight gain)

  • Latch or suck evaluation

Drop-outs
 0—Not reported
 1—Reported, drop-outs >0
 2—Reported, drop-outs = 0
 3—Reported with reason given
Losses to follow up
 0—Not reported
 1—Reported and >20%
 2—Reported and <20%
INTERVENTION
Description of treatment (1 point per criterion)

  • Type of surgery: clipping or z-plasty

  • Anesthesia or not

  • Follow-up assessment of breastfeeding

MEASUREMENT OF EFFECT
Outcome measures (1 point per criterion)

  • Duration of breastfeeding

  • Complications

  • Latch or suck evaluation

  • Breastfeeding pain or trauma

  • Objective assessment of tongue mobility

  • Speed of infant weight gain

Duration of follow-up
 1—<3 weeks
 2—3–14 weeks
 3—14 weeks-3 months
ANALYSIS AND RESULTS
Adequate analysis
 0—None
 1—Verbally described
 2—Tabulated
 3—Any statistical analysis
 4—Formal systematic analysis
Adequate presentation of data
 0—No data presented
 1—Some data presented
 2—All data presented