To help you understand the procedures for ankyloglossia surgery, it's vital to be familiar with the condition itself.
Typically, ankyloglossia is popularly known as tongue-tie, and it's a condition that's usually present during the birth of a child that restricts the motion range of the tongue. This is usually characterized by a short and tight band of tissue (lingual frenulum) that ties the underside of the tongue's tip to the mouth's floor.
As a result, this affects how the child eats, swallows and speaks. In some cases, this condition may not cause problems for the child. It can also be hard to spot in some babies and may become apparent when you notice your baby has feeding problems.
Ankyloglossia affects 4 to 11 percent of all newborns, and it's more common in boys than in girls. If your baby can feed well and has no oral problems, then treatment isn't necessary. For some babies, the lingual frenulum will loosen over time. However, if the problem is apparent, don't wait until it's too late. Some parents tend to fear their little ones undergoing surgery, and this may result in undergoing years of speech therapy, which may not fix the problem.
When ankyloglossia surgery is suggested, the procedure can be frenotomy or frenuloplasty.
Ankyloglossia surgery: This procedure is also known as tongue-tie division, and it's usually carried out by trained doctors, nurses or midwives. It's usually simple, quick and painless and doesn't require the use of anaesthesia or local anaesthetic to numb the tongue, especially in very young babies.
The doctor will examine the floor of the mouth and use sterile scissors to snip the tissue band. This doesn't cause any discomfort to the baby since there are few nerve endings in the lingual frenulum. When your baby is sleeping during the procedure, the cut won't wake them up. There may be a drop or two of blood only.
For older babies with teeth, a general anaesthetic is needed since the nerve endings would have grown. This means they'll be unconscious throughout the procedure.
Some practitioners will use a laser instead of scissors to snip the tissue band. It will take about 24 to 48 hours for the cut to heal. You can expect your baby to have easier breastfeeding after the procedure.
Ankyloglossia surgery: In some cases, the lingual frenulum can be too thick for frenotomy or the doctor may suggest a more extensive procedure to cut the band. This is where frenuloplasty comes in handy.
During this procedure, the child is given general anaesthesia, and the doctor uses surgical tools to cut the frenulum. The wound will then be closed using sutures, which absorb on their own as the cut heals.
After the procedure, doctors recommend tongue exercises to enhance the movement of the tongue and reduce the risk of scarring.
Typically, these surgeries don't have complications that you should fear. During the cutting, there might be just a few drops of blood, and this won't be a cause for concern. There might be bleeding, infection or damage, but these cases are rare. In frenuloplasty, scarring may occur due to the extensive process and the use of anaesthesia.
You can also feed your baby right after the procedure. If you feel the baby has pain or discomfort, you can give him or her pain medicine such as Tylenol.
These procedures can also be carried out in adults and older children, but stitches will be required.
Speech symptoms in children with tongue-tie vary widely, and therapy without surgery to cut the frenulum is likely to be a lengthy process. After the healing is complete, it's advisable to introduce your child to speech therapy to help in improving the articulation of specific sounds and words, such as th, sh, R, T D, N, and T.
Before the surgery, it's usually hard to tell what speech difficulties your baby will experience later. The voice problems tend to occur due to forceful phonation and stress. The emphasis of speech therapy should be to improve oral kinaesthesia and Dysdiadochokinesis to ensure the much-needed progress.
There are more than 3 million cases of ankyloglossia in the US every year. This condition inhibits the mobility of the tongue. As a parent, it's important to seek medical attention for your baby once you notice the condition.