Name of the Procedure:

Incision of Lingual Frenum (Frenotomy)

Summary

A frenotomy is a simple surgical procedure where a small cut is made in the lingual frenum, the band of tissue under the tongue that can sometimes restrict tongue movement.

Purpose

The procedure is primarily done to address the condition known as tongue-tie (ankyloglossia), which can cause difficulties in speech, eating, and, in infants, breastfeeding. The goal is to allow better motion of the tongue by releasing the tight tissue.

Indications

• Difficulty breastfeeding in infants
• Speech impediments due to restricted tongue movement
• Eating difficulties
• Dental issues related to tongue mobility

Preparation

• Patients might need to fast for a few hours before the procedure, depending on the type of anesthesia used.
• An assessment by a pediatrician (for infants) or an ENT specialist/dentist to confirm the need for the procedure.

Procedure Description

1. Anesthesia: Local anesthesia is usually applied, especially in adults or older children, to numb the area. General anesthesia may be used for infants.
2. Incision: The surgeon uses sterile scissors or a laser to make a small cut in the lingual frenum.
3. Hemostasis: Bleeding is controlled with gauze or cauterization.
4. Post-Procedure Care: The surgeon inspects the area to ensure proper release and control of bleeding.

Tools used include sterile surgical scissors, gauze, and sometimes a laser. Local anesthesia is common; however, general anesthesia may be used for very young patients.

Duration

The procedure typically takes about 10 to 15 minutes.

Setting

Frenotomy is generally performed in an outpatient clinic, a dentist's office, or a hospital outpatient surgical center.

Personnel

• Surgeon or qualified healthcare provider (e.g., ENT specialist, pediatrician, or dentist)
• Nurses or surgical assistants
• Anesthesiologist (if general anesthesia is required)

Risks and Complications

• Common: Minor bleeding, mild pain, or discomfort.
• Rare: Infection, excessive bleeding, scarring, or damage to nearby structures such as the salivary glands.

Benefits

• Improved breastfeeding in infants almost immediately.
• Enhanced speech clarity and better eating mechanics.
• Potential for immediate and long-lasting improvement in oral and dental health.

Recovery

• Post-procedure care includes gentle tongue exercises to prevent the frenum from reattaching.
• Pain is typically minimal and managed with over-the-counter pain relief.
• A soft diet may be recommended for a day or two.
• Follow-up appointment to ensure proper healing.

Alternatives

• Non-Surgical: Speech therapy or feeding therapy for infants might be suggested first.
• Pros: Less invasive, no surgical risks.
• Cons: May not be effective if the frenum is severely restrictive.

Patient Experience

• During the procedure: Minimal discomfort is expected, especially with local anesthesia. Crying and fussiness are common in infants but usually subside quickly.
• After the procedure: Some mild soreness or discomfort; pain management typically involves acetaminophen or ibuprofen.
• Gentle tongue exercises recommended to prevent reattachment and ensure smooth recovery.