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Tongue Tie


A colleague and former classmate of mine recently referred to me his 18 year old nephew because of difficulty in speech. On interview, the young lad said he sometimes find it difficult to enunciate words especially when he talks fast. On examination, his tongue assumes an apple shape when made in contact with the palate. This is a classic case of ankyloglossia.

Ankyloglossia is a congenital oral anomaly characterized by an unusually short lingum frenulum on the underside of the tongue. It is also called tongue tie. The condition can cause difficulties with breastfeeding, and speech and other problems in children and adults, including inability to lick the lips, play a wind instrument, or even with kissing.

There is a wide range of opinions regarding its significance, from having no significance to being the cause of significant problems. It is not rare though, affecting one to four babies in every 100. There is a congenital component, but we know little about other possible associations, except possibly with cocaine use in pregnancy.

Some cases may resolve spontaneously, or affected persons learn to compensate, but others may benefit from treatment.

In a study made in Stanford School of Medicine of 30 children with ankyloglossia aged 1-12 years, surgery improved tongue protrusion and elevation. In 15 children who had preoperative speech problems, improved articulation was found in nine after operation.

In 15 adolescents and adults with ankyloglossia aged 14 to 68 years, tongue protrusion and elevation were markedly less than in 20 controls. Surgery improved tongue protrusion and elevation by an average of 9 and 13 mm respectively.

I plan to do frenuloplasty by electrocautery on the patient.

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