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The Pharynx and Oral Cavity
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
Treatment in most cases involves simple division of the frenulum, with, in rare cases where the tissue is especially thickened and fixed, a frenuloplasty with a Z-plasty type repair. Newborns will tolerate a frenulotomy without the need for anaesthesia, but older children will need a general anaesthetic.
Cervicofacial Infections
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
This is a rapidly progressing cellulitis of the floor of mouth, involving the submandibular neck space. It is usually secondary to concomitant dental infections14,15 but has been described after frenuloplasty in an adolescent.16 Causative organisms include Streptococcus species, Gram-negative rods and anaerobes. Patients usually present with swelling of the neck and submandibular space as well as firm induration of the floor of mouth, resulting in elevation and protrusion of the tongue, which can lead to airway obstruction.17 Securing the airway is the mainstay of treatment, followed by intravenous antibiotics. Prompt initiation of antibiotics is usually sufficient and surgical intervention is reserved for persistent or progressive infections or when there is evidence of abscess formation.18,19 Surgical techniques for surgical decompression include intraoral and external approaches to ensure drainage of submaxillary and sublingual spaces.20,21
Oral Problems Associated with Gastrointestinal Disease
Published in John F. Pohl, Christopher Jolley, Daniel Gelfond, Pediatric Gastroenterology, 2014
The two most commonly performed procedures for ankyloglossia are frenotomy and frenuloplasty. Frenotomy (also called frenulotomy) is a simple surgical release of the frenulum. This procedure is often performed for infants with breastfeeding difficulty. Frenuloplasty is a release of the frenulum with surgical plastic repair. It is reserved for ankyloglossia that is not relieved by simple division of the frenulum, very thick frenula, or for revision cases.
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.
An evaluation of the pharmacotherapeutic options for the treatment of adult phimosis. A systematic review of the evidence
Published in Expert Opinion on Pharmacotherapy, 2022
Anna Lygas, Hrishikesh Bhaskar Joshi
“The second study, by Dahlman–Ghozlan et al. [16] was a retrospective study looking at males treated by Department of Dermatology at the Karolinska Hospital in Stockholm, Sweden. Forty four patients age 18–73 met the study enrollment criteria but only 22 men agreed to actively participate in the study and 21 completed it. The data was collected from the patients’ files as well as the follow up questionnaire and clinical follow up. Twenty men gave a consent to biopsy sampling. Primary pharmacological treatment was topical clobetasol propionate 0.05%. Twenty seven percent were cured and improvement was seen in 43% with failure in 30% requiring surgical interventions (circumcision, frenuloplasty, meatal dilatation). The follow up took place after a mean of 14.6 months.