• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.1
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• pp.5-11
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• 2000

Background and Objectives : Tongue-tie, or partial ankyloglossia, is manifested by an abnormally short and thick lingual frenulum. Degree of tongue-tie varies from the mild to the rare, severe and its treatment of choice is frenulotomy. Theoretically tongue-tie can affect expression of alveolar sounds. The purpose of this study is to evaluate the degree of articulation problem and to evaluate the efficacy of frenulotomy itself on alveolar sounds in tongue-tie patients. Materials and Methods : Prospectively, the authors performed preoperative and postoperative speech evaluation using picture consonants test for tongue-tie patients. Percentage of consonants correct(PCC), mean value of each alveolar phoneme depends on articulation site were evaluated. for exclusion of other articulatory improving factors except of frenulotomy itself, postoperative picture consonants test was performed 1 month after surgery. Results : Preoperative speech evaluation was performed to 37(male 21, female 16) patients and postoperative speech evaluation was performed to 17(male 9, female 8) patients, the other 20 patients were follow-up loss. Low PCC was observed in tongue-tie patients and PCC of female was higher an at of male in 2-4 years old patients. Overall PCC was improved after frenulotomy. Preoperative mean value of liquids and fricatives was lower than the other alveolar phonemes(p＜0.05) and it was improved postoperatively(p＜0.05). Conclusion : Frenulotomy itself can improve the articulation of liquids and fricatives on short follow-up. Speech therapy would be needful for improvement of the other alveolar phonemes.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.1
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• pp.10-15
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• 2003

Background and Objectives : Ankyloglossia, commonly known as tongue-tie, is the result of a short, fibrous lingual frenulum or highly attached geioglossus muscle. This condition may cause sucking and swallowing problems, articulation disorders, interference with the tongue's cleansing action, increased the potential for caries, and inability to lick the lips, play a wind instrument, and 'french kiss' Treatment is surgical procedure. In the most cases, horizontal sectioning and mucosal suture(the conventional procedure) is preferred, but in some cases, the Z-plastic procedure is effective. This study is aimed to compare the result of the two procedures. Materials and Methods : Twenty tongue-tie patients underwent operation. Ten patients were treated with the Z-plastic procedure and ten patients were treated with the conventional method randomly. We checked preoperative mobile tongue length, postoperative mobile tongue length, operation time and postoperative wound states. Results : Among the 20 cases of tongue-tie, 2 cases are excepted due to pre-operative state, thus we compared 18 cases of tongue-tie patients. There is no statistically significant difference between the two procedures except in operation time. The Z-plastic procedure apparently needs a little more operating time. Conclusion : Patients treated with the Z-plastic procedures appeared to have better outcomes, but the data shows no statistical significance except in operating time. Consequently, the Z-plastic procedure is indicated in a limited amount of cases.

• Korean Journal of Bronchoesophagology
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• v.2 no.1
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• pp.125-128
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• 1996

Tongue tie is the congenital anomaly which is manifested by an abnormally short and thick lingual frenulum so that a condition outside of the range of normal anatomic or functional capability. In general, the surgical correction is the treatment of choice: release of tongue tie and closure. We compared the traditional frenotomy with laser frenotomy using Nd：YAG laser to treat 67 cases of tongue tie during a period of JAN. 1993 through Feb. 1996. The advantages of laser frenotomy were decreased blood loss and operation time. So we had a conclusion as the adequate use of laser frenotomy with suture was a good surgical procedure for correction of tongue tie.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.4
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• pp.568-574
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• 2009

Tongue-tie is a congenital anomaly characterized by an abnormally short lingual frenum, which may restrict tongue tip mobility, In the neonate and infant, tongue-tie was said to cause difficult breast-feeding, In the older infant, toddler and young child, poor speech has been frequently listed because movement of tongue tip is limit ed. Also as a abnormal tongue position, various orthodontic problems, later mechanical and social manifestations could be developed. Treatment options such as observation, speech therapy, frenotomy and frenectomy have been suggested. The optimal timing for the surgery has not been determined, but early intervention may be appropriate for the children with significant tongue-tie who has the significant potential to speech difficulties and later social and mechanical problems. Sedation is an effective method for incapable of cooperative and the handicapped children, necessary to early intervention. We report three cases, using oral sedation for the frenectomy in young children with severe tongue-tie. After treatments, we could find out sufficient tongue movement and improved speech ability.

• The korean journal of orthodontics
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• v.44 no.4
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• pp.203-216
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• 2014

The purpose of the current report is to present 6-year long-term stability and 10-year follow-up data for an adult patient who was treated with a tongue elevator for relapsed anterior open-bite. The 19-year-old male patient presented with the chief complaint of difficulty in chewing his food. Collectively, clinical and radiographic examinations revealed an anterior open-bite, low tongue posture, and tongue-tie. The patient opted for orthodontic treatment alone, without any surgical procedure. A lingual frenectomy was recommended to avoid the risk of relapse, but the patient declined because he was not experiencing tongue discomfort. Initial treatment of the anterior open-bite with molar intrusion and tongue exercises was successful, but relapse occurred during the retention period. A tongue elevator was used for retreatment, because the approach was minimally invasive and suited the patient's requirements regarding discomfort, cost, and time. The appliance changed the tongue posture and generated an altered tongue force, which ultimately resulted in intrusive dentoalveolar effects, and a subsequent counterclockwise rotation of the mandible. The results showed long-term stability and were maintained for six years through continual use of the tongue elevator. The results of this case indicated that a tongue elevator could be used not only as an alternative treatment for open-bite, but also as an active retainer.

• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.3
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• pp.697-705
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• 1996

Ankyloglossia, or tongue-tie, is a congenital condition which occurs as a result of fusion between the tongue and the floor of the mouth. Ankyloglossia often results in malocclusion with an anterior "open bite" deformity, early prognathism, swallowing problem, speech disorder, and periodontal problem. Generally lingual frenectomy is used for treatment of ankyloglossia, but incomplete operation and simple frenectomy may produce a scar contracture resulting in a more deformed ankyloglossia than was present initially. The Z-plasty is used for the correction of scar contractures and the replacement of missing tissue and this procedure is ideally suited for the treatment of an ankylosed frenum. Most authors advise postponement of any decision for surgical correction of tongue-tie until the age of 4 years, unless the child is having much difficulty with sucking or swallowing. We treated 4 patients with ankyloglossia using Z-plasty technique. As a result, we found out that it was effective for correction of movement limitation of tongue, prevention of relapse. Further, periodic check ups are needed for evaluation of relapse, improvement of speech, and other functions of the tongue.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.1_2
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• pp.40-53
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• 1992

This sutdy aimed at examining the effect of lingual frenectomy on phonation & tongue movement. Almost the patient visiting to department of oral & maxillofacial surgery for the treatment of tongue tie always complain the speech problem. Many operation was performed according to this problem. But the objective evaluation of the speech change have been deficient. The experimental group was 25 adult males. Fourteen Korean consonants & after Korean vowels was combined and seventy sound was made for speech analysis. Before & after lingual frenectomy, the speech of the above mentioned group was recorded and then analysed by the Speech Workstation computer software. And before & after operation, the lingual frenum & tongue protrusion amount vas measured. The results were as follows : 1. The pre-operative length of lingual frenum was inverse proportion with the pre-operative length of the protrusive tongue. 2. The average difference between pre & post-operative length of the protrusive tongue was about 23 mm. 3. In the comparison of consonant continuing time change, fricative consonant(r, s, h) was increased post-operatively. 4. In the comparison of the vowel frequency formant change, the "i"and "u" sound vas reliably changed. 5. There was no reliable speech changes on the other sounds.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.4
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• pp.310-317
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• 2002

We have examined 20 tongue-tie patients who had been operated the lingual frenectomy in Dept. of Oral & Maxillofacial surgery, Pusan National University for the effect of the lingual frenectomy on the tongue motion and speech, and divided patients into groups by age. Each group was separated as follows ; the age of 5-6, 7-9, 10-12, 13-15, and 16-18. We measured the frenal lengh, the range of tongue motion and evaluated the speech pre- and postoperatively. The preoperative patient groups have larger tongue tips and smaller lingual frenums than normal ones. In the preoperative patient group, there was significant obstacle of the protrusive and superior movement of the tongue. The exception was the laterotrusive movement on both sides. There was the lower value of the Picture Consonant Articulation Test(PCAT) in the preoperative 5 to 6 year-old group compared with normal group. In other age groups, there was no significant difference. The range of postoperative PCAT in all age groups has become as similiar as that of normal group. The 5 to 6 year-old group which had significant difference in PCAT was improved in PCAT. In conclusion, we propose that the PCAT as well as anatomical tongue size and functional tongue movement is the basis of the indication of lingual frenectomy and the 5-6 year-old is the optimal time of the lingual frenectomy for improvement of the tongue movement and the speech.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.12 no.2
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• pp.158-160
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• 2001

Ankyloglossia is the presence of a lingual frenulum, which can range from a mucous membrane band to a short and thick band and, in extreme cases, to fusion of the tongue to the floor of the mouth. The effects of such a condition, in addition to speech defects and occasionally restriction of sucking, including dental deformities, such as open bite, or even prognathism. Treatment is surgical. The preferred treatment is horizontal sectioning of the frenulum down to the lingual septum and then suturing of the mucosa. The main problem after the healing of surgical wound is adhesion and contracture. Adhesion restrict the movement of tongue like tongue-tie. Z-plasty at the site of incision can solve this problem by changing the direction of scar. We have experienced a patient with ankyloglossia with speech defect, who underwent frenuloomy by Z-plasty. So we present a surgical treatment of Ankyloglossia using Z-plasty and discuss the treatment with a review of literature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.6
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• pp.526-534
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• 2001

Purpose : The objective of this study is to ascertain whether the positive exists among the frenum length, the tongue movement and the speech and to present the normal range of tongue movement and guidelines for the choice of surgery, observation if necessary. Materials and Methods : 180 patients were evaluated. We divided 180 patients into 6 group by age. Each group was separated as follows; the age of 2.5-4, 5-6, 7-9, 10-12, 16-18. We measured the frenal length, the range of tongue motion and evaluated the speech so that we really questioned about the positive relationship between the tongue-tie and speech. We let the patient exercise the protrusive both(right, left) laterotrusive superior movement of the tongue. During these movements, we measured the distance between the vermilion border and the tongue tip. We also measured the distance from the tongue tip to the point contacting the upper lip with dorsum of the tongue during the maximal protrusive movement of the tongue. Three linear measurement of the anterior, inferior segment of the tongue including the lingual frenum, are made. These measurements are as follows: 1. Distance A. Free anterior portion of the tongue from the point of frenular insertion to the tongue tip. 2. Distance B. The distance from the initiating point of the lingual frenum to the point connecting the two sublingual carundcles to the lingual frenum perpendicularly. 3. Distance C. The distance from the point contacting the line crossing the sublingual caruncles with the lingual frenum to the terminating point of the lingual frenum. We transform three linear measures into a statistical ratio, A/(A-B+C), representing the length of the free portion of the tongue compared with the total sublingual dimensions. In addition, we assessed the speech through Picture Consonant Articulation Test(PCAT) and tried to find out the relationship between the length of the lingual frenum and speech. Conclusion : As people are born, they have small and restricted tongue. As people grow old, tongue motions are more liberate, and unrestricted and they can speak so freely. Therefore we suggest that until age 5, oral and maxillofacial surgeons postpone the surgery if not urgent, evaluate the maximal lingual motions and PCAT according to this article and observe their changes.