Telessaúde como instrumento de triagem nos casos de anquiloglossia.

Abstract

Introduction: Ankyloglossia is a congenital anomaly that occurs when a small remaining embryological tissue causes restriction to the tongue normal movements. Inadequate tongue mobility in newborns can interfere with breastfeeding, so, the screening should occur as soon as possible, even in the Maternity, carried out by trained professionals. In some places where a shortage of such professionals occurs, especially in economically unfavorable regions telehealth can be considered an important resource. Objective: check the performance of the telehealth resource for the triage of ankyloglossia, through the application of the Bristol Tongue Assessment Tool - BTAT) Protocol and the Tongue-tie and Breastfed Babies Assessment Tool - TABBY) (, in addition to digital maneuvers for viewing the lingual frenulum according to the Tongue Frenulum Assessment Protocol in Babies. Methods: Prospective study of diagnostic test and concordance analysis, where full-term and healthy babies, born in a military hospital, from September 2021 to September 2022, had their lingual frenulum screenings performed in the first 48 hours of life, filmed and later analyzed by two experienced speech therapists remotely. The screening performed in loco was considered the “gold standard” and the expected results for the remote avaliations were normality, need for reassessment (altered or doubtful) and inconclusive. A minimum n-sample of 165 evaluations was calculated and the data were analyzed for sensitivity, specificity and inter- and intra-observer agreement using the Simple and Weighted Kappa test. The study was approved by the Research Ethics Committee of the Institution. Results: The performance of telehealth was satisfactory in the different outcomes analyzed: the sensitivity ranged from 87.06% to 89.61% in exams performed remotely and specificity was 64.08% for observer 2 and 85.23% for observer 3. The inter-observer agreement obtained by simple Kappa was moderate (0.48). The intra-observer agreement was moderate for observer 2 and strong for observer 3, both via weighted Kappa (0.49 and 0.66) and simple Kappa (0.42 and 0.67), respectively for observers 2 and 3. Conclusion: The results suggest that, in the absence of a qualified professional to carry out ankyloglossia screening in loco, Telehealth can be considered a promising tool.