Congenital Intraoral Synechiae: A Scoping Review of Airway, Feeding, and Surgical Management

OBJECTIVE: To map the existing literature on congenital intraoral synechiae and summarize reported anatomic patterns, clinical presentation, associated anomalies/syndromes, and outcomes to inform standardized diagnostic and therapeutic approaches. DATA SOURCES: PubMed, CINAHL, Embase, Web of Science, and Google Scholar were searched from January to April 2025, supplemented by reference list screening. REVIEW METHODS: This scoping review followed PRISMA-ScR recommendations. Eligible publications (1980-January 2025) were English or French reports with an abstract describing ≥1 patient with congenital intraoral soft-tissue synechiae. Two independent reviewers screened studies and extracted demographics, anatomy, symptoms, associated anomalies/syndromes, perioperative support, surgical/anesthetic techniques, and outcomes using a standardized Excel form. Data were summarized descriptively. RESULTS: 111 articles met the inclusion criteria, describing 134 patients. Alveolar synechiae were most common (70/134, 52.2%), followed by subglossopalatal (45/134, 33.6%) and glossopalatal (21/134, 15.7%); multiple synechiae types occurred in 10.4%. Restricted mouth opening was reported in 42.5%, feeding difficulties in 25.4%, and respiratory distress in 13.4%. Palatal clefts were present in 66.4%, and syndromic diagnoses included ankyloglossia superior syndrome and multiple pterygium syndromes (each 8.2%). Surgical excision was performed in 93.3%, most often within the first month of life. Among cases with reported outcomes, 80.6% recovered without complication; mortality was 6.7% overall, largely related to systemic disease. CONCLUSION: Congenital intraoral synechiae demonstrate marked phenotypic heterogeneity and frequent syndromic/multisystem associations. Early multidisciplinary evaluation, proactive airway/feeding planning, and timely surgical release are central to care. However, important gaps remain in the literature, notably the lack of standardized reporting and long-term outcome data.