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Radiosurgical Techniques
Published in Jeffrey A Sherman, Oral Radiosurgery, 2020
The maxillary frenum and the mandibular frenum are composed of fibrous connective tissue and muscle fibers which gain their origin from the periosteum covering the alveolar process and extend outward to the lips and cheeks. An unusually broad frenum can limit the motions of the lips or cheeks, as well as separating the two maxillary incisors if it connects with the palatine or incisive papilla. A frenectomy procedure is the removal of the muscle tissue by means of excision.
Infants with special needs
Published in Maria Pollard, Evidence-based Care for Breastfeeding Mothers, 2018
Frenotomy is a quick procedure that, in many cases, does not need a general anaesthetic, but a local anaesthetic is sometimes used. The infant is wrapped up and the tongue-tie divided with sterile blunt-ended scissors (NICE, 2005). The mother is given back the infant immediately following the procedure for a feed. The parents should be advised that there will be a few spots of blood only and sometimes a white patch under the tongue that resolves within 48 hours. There is a list of hospitals and contact details where frenotomy is carried out in the UK on the BFI website (www.babyfriendly.org.uk). Some tongueties resolve themselves; however, as the infant gets older it may present problems with weaning and possibly speech.
Oral cavity
Published in Paul Ong, Rachel Skittrall, Gastrointestinal Nursing, 2017
Most ankyloglossia is managed conservatively; however, where there is significant functional restriction, frenotomy or frenectomy may be performed by the surgical division of the lingual frenulum. This is usually undertaken in the first few weeks following birth without analgesia. The effectiveness of frenotomy has been shown to provide improvement to those with difficulty breastfeeding or with difficulties in speech articulation in older children and adults. There is however some controversy as to the effectiveness and timing of frenotomy.
A systematic review: The effects of frenotomy on breastfeeding and speech in children with ankyloglossia
Published in International Journal of Speech-Language Pathology, 2021
Alison Visconti, Emily Hayes, Kristen Ealy, Donna R. Scarborough
Research reports indicate that the surgical intervention, called a frenotomy, involves cutting the frenulum found between the inferior surface of the tongue and the floor of the mouth via a laser or scalpel. A frenotomy for ankyloglossia primarily occurs before 6 months, but ranges up to 6 years of age (Berry et al., 2012; Buryk et al., 2011; Emond et al., 2014; Ghaheri et al., 2017; Messner & Lalakea, 2002; O’Callahan et al., 2013; Walls et al., 2014). Frenectomies and frenuloplasties are alternative surgical interventions for ankyloglossia. A frenectomy is when the frenulum is completely excised often utilising a scalpel or laser. A frenectomy can be difficult to perform on newborns and infants and is more often performed on older children (Junqueira et al., 2014). A frenuloplasty is a more complex surgical technique conducted under general anaesthesia that restructures the frenulum using plastic surgery techniques in order to minimise postoperative scar tissue development (Baker & Carr, 2015). At this time, little research exists regarding optimal timing for intervention.
Effectiveness of frenectomy for ankyloglossia correction in terms of breastfeeding and maternal outcomes: A critically appraised topic
Published in Evidence-Based Communication Assessment and Intervention, 2019
Hannah Butenko, Vanessa Fung, Sarahlouise White
In some cases, the lingual frenulum may adapt with time and stretch with age, which positively impacts on breastfeeding efficiency, without the need for surgical intervention (Francis, Krishnaswami, & McPheeters, 2015). There is, however, conflicting evidence of whether the frenulum, given that its tissue make-up is collagen, can be stretched (Martinelli, Marchesan, Gusmao, Honorio, & Berretin-Felix, 2015). If breastfeeding difficulties persist after conservative interventions and strategies provided by a midwife or lactation consultant, a surgical procedure: frenectomy may be considered. Frenectomy (also known as frenotomy or frenulotomy) is frequently used to correct ankyloglossia by splitting the shortened frenulum using a scalpel, surgical scissors or laser.