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World J Pediatr. 2008 May;4(2):106-8. doi: 10.1007/s12519-008-0020-z.

Outpatient division of tongue-tie without anesthesia in infants and children.

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Division of Pediatric Surgery, Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan, China.



Tongue-tie is a common but often neglected condition. The indications and the techniques for its division are still controversial. In this report, I will present my personal experience and advocate early and aggressive treatment.


Two different techniques are used to divide the tongue-tie at the outpatient clinic without anesthesia. For small infants, a parent sits opposite the doctor, with their knees in contact, the infant lies supine with his/her head towards the doctor. The tongue is lifted superiorly with the doctor's middle finger or middle and index fingers. The doctor uses the other hand to divide the tongue-tie with a pair of blunt-tipped scissors. In a cooperative child with teeth and relatively thin membrane, a sitting position is used. The tongue is elevated upward with a tongue depressor and the tongue-tie is released by a quick cut.


From 1980 to 2006, about 2800 cases of tongue-tie were treated. Post-division minor bleeding in most of the cases was self-limited and always stopped spontaneously very quickly. Three patients who had recurrent tongue-tie underwent repeated division in the operating room under general anesthesia.


Division of tongue-tie is a simple, easy and safe procedure. It can be done as an outpatient procedure without anesthesia in almost all infants and some older children.

[Indexed for MEDLINE]

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