Lingual frenuloplasty with myofunctional therapy: Exploring safety and efficacy in 348 cases

Soroush Zaghi; Sanda Valcu-Pinkerton; Mia Jabara; Leyli Norouz-Knutsen; Chirag Govardhan; Joy Moeller; Valerie Sinkus; Rebecca S Thorsen; Virginia Downing; Macario Camacho; Audrey Yoon; William M Hang; Brian Hockel; Christian Guilleminault; Stanley Yung-Chuan Liu

doi:10.1002/lio2.297

Lingual frenuloplasty with myofunctional therapy: Exploring safety and efficacy in 348 cases

Laryngoscope Investig Otolaryngol. 2019 Aug 26;4(5):489-496. doi: 10.1002/lio2.297. eCollection 2019 Oct.

Authors

Soroush Zaghi^{1

2}, Sanda Valcu-Pinkerton¹, Mia Jabara¹, Leyli Norouz-Knutsen¹, Chirag Govardhan¹, Joy Moeller^{1

3}, Valerie Sinkus¹, Rebecca S Thorsen^{1

4}, Virginia Downing^{1

5}, Macario Camacho⁶, Audrey Yoon^{7

8}, William M Hang⁹, Brian Hockel¹⁰, Christian Guilleminault¹¹, Stanley Yung-Chuan Liu⁸

Affiliations

¹ The Breathe Institute Los Angeles California U.S.A.
² UCLA Health Santa Monica California U.S.A.
³ Academy of Orofacial Myofunctional Therapy Pacific Palisades California U.S.A.
⁴ Long Beach Speech Pathology Long Beach California U.S.A.
⁵ Orofacial Integrity Oakland California U.S.A.
⁶ Tripler Army Medical Center Honolulu Hawaii U.S.A.
⁷ Section of Pediatric Dentistry, Division of Growth and Development UCLA School of Dentistry Los Angeles California U.S.A.
⁸ Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery Stanford University School of Medicine Stanford California U.S.A.
⁹ William M Hang, DDS, MSD - A Prof Corp Agoura Hills California U.S.A.
¹⁰ Life Dental and Orthodontics Walnut Creek California U.S.A.
¹¹ Department of Psychiatry, Sleep Medicine Division Stanford Hospital and Clinics Redwood City California U.S.A.

Abstract

Background: Ankyloglossia is a condition of altered tongue mobility due to the presence of restrictive tissue between the undersurface of the tongue and the floor of mouth. Potential implications of restricted tongue mobility (such as mouth breathing, snoring, dental clenching, and myofascial tension) remain underappreciated due to limited peer-reviewed evidence. Here, we explore the safety and efficacy of lingual frenuloplasty and myofunctional therapy for the treatment of these conditions in a large and diverse cohort of patients with restricted tongue mobility.

Methods: Four hundred twenty consecutive patients (ages 29 months to 79 years) treated with myofunctional therapy and lingual frenuloplasty for indications of mouth breathing, snoring, dental clenching, and/or myofascial tension were surveyed. All procedures were performed by a single surgeon using a scissors and suture technique. Safety and efficacy was assessed >2 months postoperatively by means of patient-reported outcome measures.

Results: In all, 348 surveys (83% response rate) were completed showing 91% satisfaction rate and 87% rate of improvement in quality of life through amelioration of mouth breathing (78.4%), snoring (72.9%), clenching (91.0%), and/or myofascial tension (77.5%). Minor complications occurred in <5% of cases including complaints of prolonged pain or bleeding, temporary numbness of the tongue-tip, salivary gland issues, minor wound infection or inflammation, and need for revision to excise scar tissue. There were no major complications.

Conclusion: Lingual frenuloplasty with myofunctional therapy is safe and potentially effective for the treatment of mouth breathing, snoring, clenching, and myofascial tension in appropriately selected patient candidates. Further studies with objective measures are merited.

Level of evidence: 3.

Keywords: Lingual frenuloplasty; ankyloglossia; frenectomy; lingual frenum; myofunctional therapy; orofacial myology; tongue and orofacial exercises; tongue‐tie.