Development of a Tongue-Tie Case Definition (TTCD) in Newborns using a Delphi Survey: the NYU-TTCD

Abstract Objective The primary purpose of this study was to develop an operational definition of the oral condition of ankyloglossia (aka: tongue-tie) in newborns (i.e., birth-6 months) that could consistently be used in research studies. Study Design This 4-round Delphi survey developed the consensus NYU - Tongue-Tie Case Definition (NYU-TTCD) using a panel of ankyloglossia treatment experts. Results This Tongue-Tie Case Definition was carefully and step-wise created from the bottom up by expert panelists over 4 rounds of inquiry. As a functioning case definition, it offers the diagnostician two separate pathways to identifying a newborn as being tongue-tied. One pathway requires but a single pathognomonic anatomic feature while the other pathway requires a single functional deficit accompanied by at least two of 12 other diagnostic items (either functional, anatomic or behavioral). Conclusions This Delphi survey, as administered to a panel of ankyloglossia treatment experts, produced the first consensus case definition of tongue-tie for newborns, i.e., birth-6 months for use in epidemiological research studies ranging from descriptive prevalence studies to clinical trials. Next step studies should establish the validity, reliability and utility of this novel NYU-TTCD case definition for epidemiologic and clinical purposes.