Bloodless and Bladeless Lingual Frenectomy With Thermal Welding
A patient with complaints of difficulty in speaking out, talking tongue out of mouth who was 3.5 years old and tongue tie was detected on the his examination.
The process was planned using the Thermal Welding Device, which minimizes heat damage, without blisters and blades.
Prior to the procedure, thermal injury to the thermal welding method and injection of tongue tie were injected with the addition of local anesthetic, saline, and physiological saline to reduce pain.
In the new tongue tie classification, rather than the tongue tie nie structure (short, thick, corrugated ...), the placement of the tongue tie in relation to the tongue tip is taken into account. It is thought that the closer the language is to the end, the more restrictive the language movements and the more likely it will be. "Free tongue distance" is defined as the free-moving tongue tip area.
Tongue tie is cut parallel to the tongue with Thermal Welding probe. As the tongue tie is cut, it appears that the tongue tip rises back more comfortably.
The upper part of the tongue tie contains various veins, while the lower part contains salivary gland channels. Care should be taken not to damage this structure as it goes backwards.
With the suture material of the soluble feature, open mucosal areas are closed by expelling superficial mucosal seams. The tongue extension can also be sutured. Tongue tie a deep suture due to throwing, salivary gland channels and injured salivary duct (ranula) occurred cases reported.
In patients with short and proximal tongue tails, bifurcation occurs at the tongue tip from the very front of the tongue tie, depending on the effort to pull the tongue out constantly and the tongue blocking effect. There is a hollowed out area at the end of the tongue.
The sublingual area is seen in the control performed after the bloodless and blunt tongue tie operation, which is done with the Thermal Welding method, which has the lowest mucosal damage.
Mucosal damage after tongue tie operation performed by laser is more than Thermal Welding. For this reason, patients may feel more pain after tongue tie cutting than Thermal Welding method.
Tongue tie surgery in children
Tongue tie, also known as ankyloglossia, is a condition in which the strip of skin beneath the tongue (lingual frenulum) is shorter than usual, restricting the tongue's range of motion. In some cases, especially in infants and children, a tongue tie can lead to breastfeeding difficulties or other oral issues. Surgical treatment, known as a frenotomy or frenulotomy, is sometimes recommended to address this condition. Here's an overview of tongue tie surgery in children:
Indications:
Tongue tie surgery is typically considered when the condition causes significant problems such as:
Breastfeeding Difficulties: A tight or short lingual frenulum can restrict the baby's ability to latch onto the breast properly, leading to pain and difficulties for both the baby and mother during breastfeeding.
Feeding Difficulties: In older infants and children, a tongue tie may lead to difficulties with eating, speech development, or oral hygiene.
Dental Issues: A tongue tie can contribute to dental problems, such as difficulty cleaning the teeth and gums properly.
Procedure:
The surgical procedure for correcting a tongue tie is relatively straightforward and minimally invasive:
Assessment: A healthcare provider, such as a pediatrician, lactation consultant, or pediatric dentist, will assess the severity of the tongue tie and determine if surgery is necessary.
Anesthesia: In most cases, the procedure can be performed without anesthesia, especially in infants. However, local anesthesia may be considered in older children.
Frenotomy / Frenulotomy: The healthcare provider will use a small, sterile pair of scissors or a laser to make a small incision in the lingual frenulum. This procedure releases the tight tissue, allowing for increased tongue movement.
Frenectomy / Frenulectomy is defined as the removal of triangular tissue from the tongue tie tissue. After the procedure performed here, the risk of reattachment of the incision areas is lower.
Immediate Improvement: After the procedure, there is often an immediate improvement in the child's ability to breastfeed or perform other oral functions.
Postoperative Care: The healthcare provider will guide parents on postoperative care, which may include stretches or exercises to ensure that the frenulum does not reattach as it heals.
Recovery:
The recovery from a tongue tie surgery is generally quick, and most children do not experience significant discomfort. Parents are typically advised to continue breastfeeding or feeding the child as usual immediately after the procedure.
Follow-Up:
Follow-up visits are important to monitor the child's progress and ensure that the tongue tie does not reattach. Some children may benefit from the assistance of a lactation consultant to help with breastfeeding techniques.
It's important for parents to consult with a healthcare professional to discuss their child's specific situation and determine the most appropriate course of action. In some cases, a tongue tie may not cause significant problems and may not require surgical intervention. The decision to undergo surgery should be based on the child's individual needs and in consultation with healthcare providers.
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Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
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