Excision of lingual frenum (frenectomy)
CPT4 code
Name of the Procedure:
Excision of Lingual Frenum (Frenectomy)
Summary
A frenectomy is a surgical procedure that involves the removal or modification of the lingual frenum, a small fold of tissue that connects the underside of the tongue to the floor of the mouth. This procedure is performed to address issues caused by a tight or short frenum, which can affect speech, eating, and oral hygiene.
Purpose
A frenectomy addresses ankyloglossia, commonly known as tongue-tie, where the lingual frenum is too short or tight. The primary goals are to improve tongue mobility, enhance speech articulation, facilitate better oral hygiene, and prevent dental issues caused by restricted tongue movement.
Indications
- Difficulty with speech or articulation
- Trouble with breastfeeding in infants
- Problems with oral hygiene due to limited tongue mobility
- Dental issues such as gaps between teeth or gum recession
- Difficulty in eating or swallowing
Preparation
- Patients may be advised to avoid eating or drinking for a few hours before the procedure if general anesthesia is used.
- Review of medical history and current medications with the healthcare provider.
- Possible diagnostic assessments to determine the extent of the frenulum restriction.
Procedure Description
- The patient is positioned comfortably, and local anesthesia is administered to numb the area.
- Using sterile surgical instruments, a small incision is made in the lingual frenum.
- The tissue is either removed or released to allow for greater tongue mobility.
- The wound may be closed with absorbable sutures if necessary.
- The procedure is typically brief, and the patient is monitored for a short period post-operation.
Duration
The procedure usually takes about 15 to 30 minutes.
Setting
A frenectomy can be performed in an outpatient clinic, a dental office, or a surgical center.
Personnel
- Oral surgeon or dentist
- Surgical nurse
- Anesthesiologist (if general anesthesia is used)
Risks and Complications
- Mild bleeding
- Infection at the incision site
- Swelling and discomfort
- Rarely, damage to nearby structures
- Recurrence of tongue-tie (very rare)
Benefits
- Improved tongue mobility and function
- Enhanced speech clarity
- Easier eating and swallowing
- Better oral hygiene
- Relief from associated dental problems
Recovery
- Patients are typically able to eat and speak shortly after the procedure.
- Pain management may include over-the-counter pain relievers and ice packs.
- Good oral hygiene practices, such as rinsing with salt water, are recommended.
- Follow-up appointments to monitor healing and progress.
- Recovery time is generally a few weeks, with most symptoms resolving in a few days.
Alternatives
- Stretching exercises to improve tongue mobility (may not be effective for severe cases)
- Speech therapy to address articulation issues
- Observation and non-surgical management if symptoms are mild and do not interfere with daily activities
Patient Experience
- During the procedure, patients might feel pressure but little pain due to anesthesia.
- Post-procedure, mild discomfort and swelling are common, but manageable with pain relief measures.
- Rapid improvement in tongue mobility and associated symptoms can be expected, contributing to overall comfort and quality of life.