About The Surgical Techniques For Tongue Tie Release
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| Tongue Tie |
Tongue tie (lingual frenulum) is a structure between the tongue and the base of the mouth that restricts the movements of the tongue. Tongue tie is defined as "hypertrophic lingual frenulum", "ankyloglossia" or roughly "Tongue tie" when it is shorter and thicker than normal.
Tongue ties are divided into two main groups as anterior and posterior (submucosal tongue tie); the anterior tongue ties can be grouped as type 1,2 and 3 tongue tie and the posterior tongue tie as type 4 tongue tie.
Tongue tie release procedures can be performed under local anesthesia or general anesthesia. Scissors, scalpel, electrocautery, thermal welding method, laser and bipolar radiofrequency methods can be performed using tongue tie surgery.
So what method of tie surgery is the best?
Dr. Kotlow describes the newly published classification system for tie, and one of the physicians who described techniques for tongue tie surgery. Dr. Lawrence Kotlow has been practicing laser ligament surgery and other methods for many years and has published a number of studies on the subject. |
| Type 3 tongue tie in adult patient |
The advantages and disadvantages of tongue tie release methods can be explained as follows:
- It is the method where the mucosal damage is the least when using scissors and scalpel. However, the tongue may not be very suitable in patients with thick veins and thickening because the procedure does not have the ability to stop bleeding at the same time.
- When radiofrequency and electrocautery are used, severe mucosal damage due to increasing temperature up to 400 degrees may occur. Although it may be suitable for tie varieties, thick and veined tongue can also reduce bleeding at the same time; is a method I prefer not to be very bad due to damage.
- Tongue tie surgery with laser, perfect stopping of bleeding is a method that allows tissue to be cut at the same time. However, because the mucosa ends on the two sides of the laser-cut incision are usually serious, the healing can be completed longer than the incision made with the scissors. In addition, the laser method is the most expensive of these methods.
- Thermal welding is a good way to limit heat damage to only about 2 mm. Minimizes mucosal damage in the incision line. Since the probe is usually used for single use or a maximum of a few patients, it requires additional processing cost, although not as much as the laser.
When the tongue tie in infants is thin membrane, breast-feeding with breast milk after the controlled tongue tie release process with scissors increases the healing rate to the maximum.
Frenotomy or Frenectomy?
Tongue tie tissue surgical removal (lingual frenectomy) is an application that reduces the likelihood of re-adhesion after lingual frenulotomy. For the above mentioned surgical instruments used during the procedure; There are some applications in the form of removing the tie tissue from the tongue during processing.Lingual Frenectomy With Scissor Video
In the above video, under the lingual frenectomy operation with scissors made under office conditions and local anesthetic injection, there is a sublingual appearance immediately before and after 1 week.
Bloodless and Bladeless Lingual Frenectomy With Thermal Welding Device
Above you can watch a video of a tongue tie surgery (frenectomy with thermal welding device) under sedation and local anesthesia for an adult patient.
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
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Appointment Phone: +90 212 561 00 52
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