As regards the ENT's decision not to release the tongue tie, I have had the same experience with our ENT with whom
we have built a good relationship. On the odd occasion he will say that the tongue tie is too thick and vascular to do a
release in the office. I am happy to leave this decision to the person who has more knowledge than me as regards
blood and nerve supply to the tongue. As the expert in that regard the ENT takes responsibility for the outcome of his procedure and he needs to be comfortable that it can be done safely. 

I had an interesting experience this week with an ENT telling me that we should not be talking about "posterior tongue ties", but call them "vascular" instead. I told her that I did not invent the terminology and in my frame of reference I understand why it is posterior as opposed to the more classic tongue tie, but she insisted that the tie is not posterior, but thick and vascular, so I wondered whether we were talking about the same thing?

 I attended a meeting this week where a large group of surgeons,  orthodontists, ENT's and speech language therapists from NZ and Australia attended. A Paediatrician that presented  set the ball rolling referring to all the babies who now suddenly need tongue tie release and from the response to this I realized that tongue tie is still a hot topic and we do need to do everything in our effort to educate people about it because clearly Lactation Consultants need the procedure to be performed to support their patients. We have done the work around demonstrating why it is necessary and it is now acknowledged in the literature as best practice for breastfeeding issues.

I think one thing that will be helpful in developing services for tongue tie would be for all referrals to ENT's to always be  accompanied by an assessment e.g. the Hazelbaker assessment. If we send a referral that substantiate clearly what the shortcomings are, we demonstrate that we have done more than just noticing a tongue tie and this will also  help to educate our ENT colleagues on why release is indicated and that what is in front of them is not "a normal tongue".
Loraine Hamm
SLT/IBCLC
New Zealand


 

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