- Lingual and Maxillary Labial Frenuloplasty with Myofunctional Therapy as a Treatment for Mouth Breathing and Snoring. [Case Reports]
- CRCase Rep Otolaryngol 2019; 2019:3408053
- Chronic mouth breathing may adversely affect craniofacial development in children and may result in anatomical changes that directly impact the stability and collapsibility of the upper airway during…
Chronic mouth breathing may adversely affect craniofacial development in children and may result in anatomical changes that directly impact the stability and collapsibility of the upper airway during sleep. Mouth breathing is a multifactorial problem that can be attributed to structural, functional, and neurological etiologies, which are not all mutually exclusive. While therapeutic interventions (myofunctional, speech and swallowing, occupational, and craniosacral therapy) may address the functional and behavioral factors that contribute to mouth breathing, progress may sometimes be limited by restrictive lingual and labial frenum that interfere with tongue and lip mobility. This case report explores the case of a three-year-old girl with mouth breathing, snoring, noisy breathing, and oral phase dysphagia that was successfully treated with lingual and labial frenuloplasty as an adjunct to myofunctional therapy. Within four days of the procedure, the patient had stopped snoring and demonstrated complete resolution of open mouth breathing. The patient was also observed to have increased compliance with myofunctional therapy exercises. This report highlights the effectiveness of surgical interventions to improve the efficacy of myofunctional therapy in addressing open mouth posture and low tongue resting position.
- Meatal stenosis after surgical correction of short frenulum: Is the "pull-and-burn" method the way to go? [Journal Article]
- UAUrol Ann 2018 Oct-Dec; 10(4):354-357
- CONCLUSIONS: The "pull-and-burn" method is a simple and safe procedure for the correction of short frenulum that respects anatomically the delicate vasculature of the frenular area, resulting in the preservation of the integrity of the urethral meatus.
- Results of tubularized urethral plate urethroplasty in Megameatus Intact Prepuce. [Journal Article]
- IJIndian J Urol 2017 Oct-Dec; 33(4):315-318
- CONCLUSIONS: Surgical correction of MIP in the era of increased cosmetic awareness is justified. Excellent results are obtained with TUPU and along with spongioplasty and frenuloplasty because of availability of wide urethral plate and well-developed spongiosum in these patients. TUPU should be the preferred procedure in cases of MIP.
- Frenectomy for the Correction of Ankyloglossia: A Review of Clinical Effectiveness and Guidelines [BOOK]
- BOOKCanadian Agency for Drugs and Technologies in Health: Ottawa (ON)
- One medical condition associated with breastfeeding problems is ankyloglossia, or tongue-tie, a congenital anomaly in which a child is born with an abnormally short and/or thick lingual frenulum that…
One medical condition associated with breastfeeding problems is ankyloglossia, or tongue-tie, a congenital anomaly in which a child is born with an abnormally short and/or thick lingual frenulum that limits the movement of the tongue. It has been associated with difficulty breastfeeding due to trouble latching on, associated nipple pain, infection, and poor milk supply in mothers, as well as discontinuation of breastfeeding and inadequate weight gain and other health issues such as oral hygiene concerns, speech problems, and developmental and social consequences. Ankyloglossia has a hereditary link, but not all cases are explained by genetics. A review of studies reporting on prevalence of ankyloglossia in the United Kingdom and USA suggested that rates likely fall between 4 to 10%, occurring more commonly in males, though inconsistency in diagnostic procedures may contribute to variation in estimates. There is no clinical standard for diagnosing ankyloglossia, but assessment tools such as the Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF), which is considered comprehensive, but difficult to use, and the Bristol Tongue Assessment Tool (BTAT), which is simpler and aims to ease implementation, are cited in the literature. Diagnoses may also be made using subjective clinical judgement by practitioners with varying levels of experience or expertise. The condition can entail mild immobility or be as severe as fusion of the entire tongue to the floor of the mouth. The condition can be anterior or posterior, and may be comorbid with other issues such as upper lip-tie. To correct ankyloglossia, splitting of the tongue-tie, termed frenectomy (also commonly referred to as frenotomy or frenulotomy), is often proposed. It can be conducted using a laser, scalpel, or surgical scissors, and the laser procedure is suggested to be more accurate, and provide greater patient-perceived success, and hemostasis. Frenuloplasty (also called Z-plasty) is a type of tongue-tie release often conducted with anesthetic in which more precise incisions and closure of the wound in a specific pattern occurs, with the aim of lengthening the anterior tongue. Simple release is a procedure in which the frenulum is detached without any wound closure or alteration, usually without anesthetic. Based on population data from British Columbia, the rate of frenotomy increased by 89% from 2004 to 2013, rising from 2.8 to 5.3 per 1000 live births. This suggests a possible increased awareness, interest in frenotomy, and increase in diagnostic capacity. There is disagreement across specialties regarding whether a tongue-tie should be divided to facilitate breastfeeding, and under what circumstances. Ankyloglossia is not the only cause of breastfeeding issues, and in cases of comorbidities or alternative primary causes, frenectomy may not result in resolution. Un-split lingual frenulum may physically adapt (i.e., stretch with age) over time and breastfeeding quality may improve without intervention. The Canadian Paediatric Society has communicated that under most circumstances, tongue-tie is an incidental anatomical finding without significant consequences for the quality of breastfeeding, and that surgical intervention may not be warranted unless difficulty breastfeeding or other clinical concerns present themselves. The National Institute for Health and Care Excellence in the UK released guidance in 2005 which reported that current evidence was suggestive of no major safety concerns with frenectomy, and that there was limited evidence that it might improve breastfeeding. Considering uncertainties regarding the clinical effectiveness and appropriateness of the procedure, and the development of new technologies and methods of conduct, this report aims to review the current clinical evidence regarding the effectiveness of frenectomy in newborns and infants with ankyloglossia, as well as evidence-based guideline recommendations for the use of this procedure.
- Diagnosis and treatment of ankyloglossia: A narrative review and a report of three cases. [Case Reports]
- QIQuintessence Int 2016; 47(6):523-34
- CONCLUSIONS: Frenuloplasty is a safe, quick, effective, and economical method and for this reason the parents should not hesitate towards frenulum release. More clinical studies are needed to confirm the benefits of the surgical interventions and to compare the results with those obtained using nonsurgical therapy or with untreated cases.
- Modified Tubularized Incised Plate Urethroplasty Repair: Frenuloplasty and Long-Term Results in 155 Patients. [Journal Article]
- IJIndian J Surg 2015; 77(Suppl 2):212-5
- To describe a modification of tubularized incised plate (TIP) urethroplasty which we refer to as "frenuloplasty". We retrospectively reviewed 155 children who underwent TIP urethroplasty between June…
To describe a modification of tubularized incised plate (TIP) urethroplasty which we refer to as "frenuloplasty". We retrospectively reviewed 155 children who underwent TIP urethroplasty between June 2008 and August 2011 in our institution. In our technique, the circumcision incision went on through the mucocutaneous junction obliquely in order to form frenular wings instead of linear circumscribing incision joined the urethral plate vertically. The little triangle-shaped skin flaps between the oblique mucocutaneous incisions and urethral plate incisions were excised. The glans wings and frenular wings were re-approximated without tension after uretroplasty. The mean age of the patients was 4.63 ± 3.82 years. The mean follow-up was 15.94 ± 5.46 months. Location of hypospadias was distal penile in 126 patients (81.3 %) and mid-shaft in 29 (18.7 %). The following complications occurred in 21 patients (13.5 %): urethrocutaneous fistula formation in 7 (4.5 %), meatal stenosis in 14 (9 %) and no dehiscence. We suppose that there is no incompletely formed prepuce but a ventral fusion defect in the midline. Frenuloplasty reduces the necessity of ventral preputial flaps and provides satisfactory cosmetic outcomes with the appearence of normal circumcised penis.
- Treatment of ankyloglossia for reasons other than breastfeeding: a systematic review. [Review]
- PedPediatrics 2015; 135(6):e1467-74
- CONCLUSIONS: Data are currently insufficient for assessing the effects of frenotomy on nonbreastfeeding outcomes that may be associated with ankyloglossia.
- Tongue-tie Repair: Z-Plasty Vs Simple Release. [Journal Article]
- IJIran J Otorhinolaryngol 2015; 27(79):127-35
- CONCLUSIONS: Z-plasty is the preferred surgical method to address tongue-tie due to a greater improvement in mother's breast pain, pronunciation and speech, tongue movement, and parental satisfaction.
- Surgical speech disorders. [Review]
- FPFacial Plast Surg Clin North Am 2014; 22(4):593-609
- Most speech disorders of childhood are treated with speech therapy. However, two conditions, ankyloglossia and velopharyngeal dysfunction, may be amenable to surgical intervention. It is important fo…
Most speech disorders of childhood are treated with speech therapy. However, two conditions, ankyloglossia and velopharyngeal dysfunction, may be amenable to surgical intervention. It is important for surgeons to work with experienced speech language pathologists to diagnose the speech disorder. Children with articulation disorders related to ankyloglossia may benefit from frenuloplasty. Children with velopharyngeal dysfunction should have standardized clinical evaluation and instrumental asseessment of velopharyngeal function. Surgeons should develop a treatment protocol to optimize speech outcomes while minimizing morbidity.
New Search Next
- Effectiveness of tongue-tie division for speech disorder in children. [Journal Article]
- PIPediatr Int 2015; 57(2):222-6
- CONCLUSIONS: Substitution and omission improved relatively early after tongue-tie division and progressed to distortion, which is a less-impaired form of articulation disorder. Thus, distortion required more time for improvement and remained a defective speaking habit in some patients.