Management of posterior ankyloglossia and upper lip ties in a tertiary otolaryngology outpatient clinic

Lingual Frenulum Phenotypes in Brazilian Infants With Congenital Zika Syndrome

“…In the present study, examination of infants with CZS demonstrated that 37% (n = 20) of these patients had a posterior lingual frenulum and required elevation followed by the posterior maneuver of the tongue to adequately visualize the tissue. This prevalence was higher than previously reported results among healthy infants (Hong et al, 2010; Martinelli et al, 2013; Haham et al, 2014; Dollberg et al, 2014; Pransky et al, 2015; Marcione et al, 2016) and was only lower than the prevalence from studies that favored the recruitment of patients with this type of frenulum attachment (Benoiton et al, 2016; Callahan et al, 2013).…”

“…Dollberg et al (2014) prospectively followed 244 infants who underwent frenotomy and reported a 32% prevalence of posteriorly positioned lingual frenulum (n = 78). Benoiton et al (2016) (46.5%, n = 20/43) and Callahan et al (2013) (47%, n = 145/311) reported exceptionally high percentages of posterior lingual frenula. In these studies, samples consisted mainly of infants referred for frenotomy due to the presence of posterior ankyloglossia and/or upper lip tie (Benoiton et al, 2016) or infants with problematic ankyloglossia (Callahan et al, 2013), explaining the higher prevalence of posterior lingual frenula.…”

“…Benoiton et al (2016) (46.5%, n ¼ 20/43) and Callahan et al (2013) (47%, n ¼ 145/311) reported exceptionally high percentages of posterior lingual frenula. In these studies, samples consisted mainly of infants referred for frenotomy due to the presence of posterior ankyloglossia and/or upper lip tie (Benoiton et al, 2016) or infants with problematic ankyloglossia (Callahan et al, 2013), explaining the higher prevalence of posterior lingual frenula. In the present study, examination of infants with CZS demonstrated that 37% (n ¼ 20) of these patients had a posterior lingual frenulum and required elevation followed by the posterior maneuver of the tongue to adequately visualize the tissue.…”

“…Many studies do not describe the use of specific tongue maneuvers or devices to diagnose the presence/absence of a lingual frenulum, suggesting visual inspection or the use of simple elevation maneuver as a means for diagnosis. Along these lines, different devices and/or tools have been used to aid in the assessment of lingual frenulum insertion and anatomy, such as metal grooved elevator (Benoiton et al, 2016), groove director (Chu and Bloom, 2009), the Pradhan retraction device (Pradhan et al, 2013), the Hazelbaker assessment tool for lingual frenulum function (Hazelbaker, 2010), the Bristol tongue assessment tool (Ingram et al, 2015), Murphy maneuver (Pradhan et al, 2013), among others. Therefore, there are various methods that may be used to assess the presence/absence of ankyloglossia, and the lack of a standardized assessment tool may explain the insufficient agreement between studies.…”

Upper lip tie wrapping into the hard palate and anterior premaxilla causing alveolar hypoplasia

“…It is reported that frenulotomy of upper lip tie alone results in low recurrence rate and high improvement rate of breast feeding [ 1 , 3 , 7 ]. For mild upper lip tie, simply dividing of frenulum by iris scissor can be the treatment of choice [ 7 ]. But this particular case is severe upper lip tie resulting alveolar hypoplasia, abnormal lip motion and contour for child.…”