The value of frenotomy for ankyloglossia from a parental perspective.

AIMS: We sought the parental experience of the effects of frenotomy in the presence of ankyloglossia by exploring the reasons for seeking frenotomy, impressions of its value and its impact on breastfeeding. METHOD: A prospective survey of infants receiving frenotomy in a general practice in Palmerston North was undertaken. Infants aged under six months with confirmed ankyloglossia via a GP and lactation consultant were included. One hundred and seventy-six children met the study criteria. Parents completed a pre-procedure questionnaire and received a follow-up phone call. RESULTS: Results demonstrated that 97% of parents would seek out frenotomy again in similar circumstances. Initially, 93 mother-infant pairs (53%) were not fully breastfeeding; post frenotomy, 33 of these pairs were able to start fully breastfeeding. One hundred and thirty-two pairs showed no change in feeding method. Nine pairs deteriorated from partial breastfeeding to artificial feeding, and two pairs deteriorated from fully breastfeeding to artificial feeding. Both feeding time and nipple pain improved post-frenotomy. Eighty percent of parents reported a moderate or significant improvement in their presenting issue, and 77% reported moderate to significant improvement in feeding quality. There were no major complications. CONCLUSION: Frenotomy was reported to be beneficial, with a high level of parental satisfaction and improvement in rates of full breastfeeding and feeding duration, as well as a reduction in nipple pain. Parents were willing to go to significant lengths to access the procedure.

Human vitreous distribution of linezolid after a single oral dose.

PURPOSE: To evaluate the relationship between vitreous linezolid concentrations versus both time and serum concentrations after a single 600 mg oral dose. METHODS: Two groups of six subjects undergoing a pars plana vitrectomy indicated by macular pucker or full thickness macular hole were given a single tablet of linezolid before surgery. The early group underwent vitrectomy at random times before the time of maximum serum linezolid concentration (i.e., 77 minutes) and the late group underwent vitrectomy at random times afterward. Each patient had a serum sample drawn shortly before and after vitrectomy and the vitreous specimen was sampled at the initiation of surgery. RESULTS: The early group and late group had mean vitreous linezolid concentrations of 0.06 mcg/mL and 1.25 mcg/mL, respectively. The vitreous linezolid concentration showed a strong correlation to the interpolated serum concentration (R2 = 0.74, P < 0.01) at the time of vitrectomy. CONCLUSION: The study demonstrates that linezolid penetrates the blood-retina barrier in noninflamed eyes. Because the vitreous concentrations appeared to exponentially trend upward with time and 33% of the late group achieved sufficient MIC90 levels for the common pathogens found in postoperative endophthalmitis, adequate concentrations might be achieved with an altered dosing regimen to achieve higher serum steady state levels. Further study is warranted.