Language frenulum surgery is a necessary procedure for those who are faced with the problem of a short frenulum or its incorrect location. It is a full-fledged operation, and therefore the need for it must be clearly justified.
Purpose of the bridle of the tongue
The frenulum of the tongue is one of the most important elements in the oral cavity. It is a fold of mucous membrane. The frenulum is located from the base of the gums to the middle of the tongue. Often there are cases when the bridle requires surgical intervention. Surgery is mandatory in many cases. Therefore, before revealing the features of such an intervention, it is necessary to say what functions the fold performs and what its defects are fraught with.
The bridle is a part of the tongue, which, despite the fact that it is almost invisible, carries a very large functional load. It performs the following functions:
- fixes the tongue in the mouth;
- forms bite;
- prevents tugging and sinking of the tongue;
- determinespurity of sound pronunciation;
- contributes to the normal functioning of facial muscles;
- prevents pathology of glossoptosis in children and adults, which causes retraction of the tongue and disruption of all its functions.
Complications of frenulum defect
A frenulum defect leads to serious complications from the age of four. During this period, the child develops pronunciation and actively develops speech. Therefore, from this period, there is an active development of complications in people with a short or incorrectly located frenulum.
Such complications include:
- Problems with the pronunciation of the sounds "l", "r" and hissing.
- Difficulty swallowing.
- Formation of malocclusion.
- Curvature of the smile due to the displacement of the anterior incisors back.
- Underdevelopment or slow growth of the lower jaw.
- Possible respiratory failure.
- Fast onset of mouth muscle fatigue while eating or talking.
- Retracting the gums down, as a result of which the roots of the teeth are exposed and diseases of the teeth and gums appear.
- Difficulty in wearing dentures in adults and the elderly due to the aggravation of dental problems over time.
Based on the foregoing, we can say that a defect that is imperceptible at first glance can lead to serious he alth and appearance problems in the future.
Checking the hyoid frenulum
One fourth of all cases of anomaly is detected in the first days of life, even before discharge from the hospital. It is not necessary to identify such cases.special examination as breastfeeding these children is difficult.
According to statistics, an anomaly of the frenulum occurs in men much more often than in women, in almost fifteen percent of the world's population. For women, this figure is three times lower.
If the pathology was not noticed in infancy, at an older age it is determined by the following signs:
- Children have trouble lifting their tongue even a little.
- Limits the functionality of the tip of the tongue, which is due to the fact that it is drawn to the lower part of the mouth.
- When pulling out or lifting the tongue, its tip cannot be pointed (it visually bifurcates).
- When the tongue is pushed forward, its tip is bent down.
- Child has difficulty licking ice cream and lips, and playing flute, trumpet and other wind instruments.
It is also possible to diagnose the problem at home. If a child, at the request of the parents, can easily touch the sky with the tip of the tongue, then there is no pathology. If this is difficult for him, then you need to contact a specialist.
In most cases, it is difficult to diagnose the problem yourself, as the shortening can be small. Therefore, in the maternity hospital, defects are detected by a neonatologist, and in children of kindergarten age, by a dentist or speech therapist.
Causes of pathology
Pathology can be hereditary, congenital or obtained as a result of external influence on the fetusduring pregnancy.
If the problem is hereditary, then it must have been in the mother, father or other close relatives. Congenital deformity of the mouth is also possible. For example, the presence of a split palate, which was formed due to changes in the X chromosome.
The mother can also be the problem. For example:
- passing serious infectious or viral diseases during pregnancy;
- Maternal alcohol abuse during early pregnancy;
- late pregnancy;
- mother getting an abdominal injury during pregnancy, for example, a bruise or a fall;
- adverse environmental situation.
Types of pathology
Pathology can manifest itself in the incorrect attachment of the frenulum (ankyloglossia) or its small size (dysarthria).
In ankyloglossia, the fold is located unphysiologically, that is, its upper tip is attached very close to the tongue tip. In this case, the size of the bridle can be standard.
With dysarthria, the size of the frenulum is less than the prescribed 2.7-3 centimeters. Depending on the size of the fold, there are three degrees of dysarthria:
- Light (if the length of the fold is more than one and a half centimeters) - a defect that causes problems with the pronunciation of sounds. Such deviations can be corrected by a speech therapist by stretching the fold.
- Medium (if the length of the fold is less than one and a half centimeters) - a defect corrected by speechtherapy. If it was not successful, then plastic frenulum of the tongue is performed in children.
- Severe (if the length of the fold varies from five to ten millimeters) - a defect that can only be corrected by surgery with postoperative speech therapy.
Effects of a short fold in babies
Before talking about the cases in which the plastic of the frenulum of the tongue is done, a number of points should be noted. Violation of the normal functioning of the tongue leads to the formation of malocclusion and delay in jaw development. Moderate and severe pathology is detected from infancy.
When ankyloglossia there are problems with the organization of breastfeeding. Due to a serious deviation, children are malnourished due to the fact that they quickly get tired. Because of this, the feeding process is delayed.
In this regard, babies have problems during breastfeeding:
- Weight loss due to malnutrition. Due to rapid fatigue, the baby refuses mother's milk, not satisfied.
- Problems attaching to the mother's breast, resulting in possible damage to the mother's nipples.
These problems are related to the fact that when breastfeeding, the baby must use the tongue to help the flow of milk from the mammary gland to the nipple. With a short bridle, such a movement is difficult to carry out. Therefore, it is easier for such babies to take food from a bottle. After being switched to solid food, the discomfort disappears in most cases.
Indications for plastic surgerybridles
In most cases, children eventually get used to the fact that their language is not fully functioning. In addition, very often the fold stretches with age and becomes a normal size. Therefore, if a child has defects in the frenulum, you can wait for some time for self-correction of the pathology. If there are no changes, you need to contact a specialist and make a plastic frenulum of the tongue.
It is important for parents to understand that even if the child does not feel severe discomfort, in the process of growing up, the pathology of the fold can cause some problems. Therefore, the plastic of the frenulum of the tongue in children must be done.
Indications for an operation to restore the functioning of the frenulum in full by age are as follows:
- for newborns - for sucking problems;
- for preschoolers - if there are difficulties with diction and pronunciation;
- for preschoolers and schoolchildren - with a slowdown in the growth of the lower jaw, which can cause the incisors to roll inwards;
- for people of different ages - if necessary, wearing braces and other similar structures;
- for adults - if it is necessary to install dentures, because due to the pathology of the fold, removable dentures can fly off the lower part of the jaw;
- for adults and the elderly - at the preparatory stage of prosthetics with implants, since over-implantitis can develop if the fold is incorrectly positioned.
Contraindications for tongue frenuloplasty
There are times whensurgery is strictly prohibited. These cases include:
- presence of cancer;
- blood clotting problems;
- presence of infectious diseases;
- inflammation of the mucous membrane;
- presence of untreated teeth and pulpitis.
For minors, contraindications are the lack of parental consent and the absence of a speech pathologist's opinion. A speech therapist and a dental surgeon jointly determine the possibility of stretching the frenulum without surgery, using speech therapy massage. In addition, the speech therapist determines the balance of benefits and risks of surgery. With various disorders of speech development (general underdevelopment of speech, dysarthria or psychomotor retardation), plasty of the frenulum of the tongue in children can lead to a worsening of the speech therapy defect.
Age restrictions
If the pathology of the fold was detected in the maternity hospital due to problems with the baby's nutrition, it is best to do a frenuloplasty right away. In newborns, surgery is to cut the frenulum.
As for older children, the opinion of doctors here is divided. Some say that plastic surgery should be done immediately upon detection, while a scar may appear on the dissected site, requiring a new surgical intervention in the future. According to other reviews about plastic frenulum of the tongue, the operation should be performed when the child reaches the age of four years, if there are obvious speech problems. At the same time, a speech therapist after the operation to visitwill have in any case to restore speech skills in full.
There are no age restrictions for adults. Tongue tie surgery for adults can be done at any time.
Surgical options
Types of surgical intervention, as well as reviews of plastic frenulum of the tongue in adults and children, are different.
Fix the bridle using one of the following types of surgery:
- phrenotomy;
- frenectomy or frenuloplasty;
- laser method.
Frenotomy is used to cut the fold in infants. In newborns, there are no blood vessels in the frenulum, so the tissue on it is whitish. In this regard, neither suturing nor anesthesia is used during the operation. The dissection of the fold is performed with special surgical scissors. If there is a slight bleeding after surgery, it will stop if you put the baby to the breast.
A frenectomy in older children is called a frenectomy. Since the blood vessels in the fold are already formed, the operation is performed under anesthesia with suturing. There are several types of technology:
- cutting the bridle;
- bridle removal;
- change the stapling location.
When cutting the fold, its dissection is carried out, and then its lateral edges are sutured, while capturing deep tissues.
When using the traditional technique, the mucosal fold is cut, a submucosal flap is formed, and then the place of attachment of the frenulum is transferred. Then suturing takes place.
According to reviews, plastic surgery of the frenulum of the tongue with a laser is the most sparing method of surgery. This type of surgery has a number of advantages:
- operation is carried out within five to six minutes;
- no pain;
- bleeding after surgery is excluded;
- you can easily predict the results of the operation;
- comfortable conditions;
- no suturing step;
- speedy recovery;
- accuracy of the procedure;
- Protection against bacteria and microbes entering the wound.
In laser plastic surgery of the frenulum of the tongue, the specialist first places a tampon soaked in an anesthetic composition under the patient's tongue and makes an injection of anesthesia. Then, to cut the fold, he directs the tip of the laser device to the frenulum. The device generates a laser that dissolves the crease. After the operation, medicines are applied to the wound, which speed up the healing process. The recovery period after such a procedure is about two days. Laser plasty is the fastest and most convenient way of operation.
In order to avoid complications after surgery, several postoperative recommendations must be followed:
- Two hours after frenuloplasty do not eat.
- Within a few days after the operation, you need to exclude from the diet foods that can irritate the wound (acute, sour, hard, s alty).
- Avoid excessivetension of the vocal cords and speech apparatus.
- About the crescent, take extra care of your mouth and rinse your mouth with antiseptics.
- Perform special language exercises prescribed by your doctor.
If all these requirements are met, the fact of surgical intervention will not subsequently cause any inconvenience.
Reviews of the frenulum plastic procedure are different. For the most part, the parents of the operated children and the adults themselves speak positively about the procedure itself. Another issue is the negligent attitude of the staff of the medical dental institution where the operation was performed. Here opinions differ. At the same time, if the staff reacted to the procedure in good faith, then, judging by the reviews, there will be no problems in the future.
Prices for cutting or transferring the frenulum also vary greatly. They vary from five hundred to seven thousand rubles, depending on the clinic and the technique of the procedure.
You can see many photos of frenuloplasty, especially with a laser. Therefore, if a similar problem arose, do not pull. You need to contact a specialist immediately, until you have to deal with the consequences of inaction.
