Tongue Tie or “Ankyloglossia” or “anchored Tongue” is a common yet unidentified condition, occurring during birth, causing a wide range of difficulties as one grows up, if left untreated. Correct diagnosis is very crucial for remedial action. Today, many diagnostic methods have evolved that help further course of treatment. Tongue tie affects the structure and appearance of face and oral functions like eating, digestion, speech, growth of teeth, kissing and social skills that has an adverse effect on the patient as he grows up. Some symptoms like
breast feeding difficulties are detected early whereas other aspects like speaking and growth of teeth become apparent only later. Surgical procedure offers a permanent solution and can be performed anytime between 7 days to 70 years of age.
Surgery can be performed if other forms of treatment like speech therapy do not fetch desired results. However, proper diagnosis and identification of tongue tie as the cause of difficulties related to speech is very essential before opting for surgery. Expertise of the surgeon is an important factor to be considered before considering operation in a particular hospital.
How the surgery is performed
The surgery may involve snipping the frenum – the string that connects the tongue to the base of the mouth (frenotomy) or surgical revision of the frenum (frenectomy) by conventional method, laser or using a Coblator.
Snipping requires no anaesthetic or analgesic. The baby’s tongue is stretched out with the surgeon’s left index finger, when he holds the lower lip with the thumb. The tie is divided with a blunt-ended sterile scissors and the floor of the mouth is compressed with gauze. Immediately the child can be breast fed with significant improvement in sucking.
However if shortening of the genioglossus muscle is required, surgery under general anaesthesia may be required. Discomfort may be felt that may ease out after 10 days. Speech therapy has to be followed.
If done using laser, the procedure only requires an analgesic gel to be applied. The entire procedure takes only around 4 minutes. The procedure does not involve bleeding or pain.
The surgery may also be carried out using a coblator that does not involve blood loss or pain.
Optimal management of tongue tie with surgical intervention followed by speech therapy brings pleasing results at shortest possible time.
Authored by Dr Shailesh Pandey, ENT Specialist
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