What is a tethered tongue?
A tethered tongue (or, tongue tie) is also known as ankyloglossia. It occurs during development when the front of the tongue is anchored to the floor of the mouth by a piece of tissue called the frenulum. This can limit movement of the tongue and infrequently causes speech or feeding problems. The actual incidence is unknown, but is estimated to occur in 3-5 percent of newborns, with a slight prevalence in boys.
Why does tethered tongue occur?
Tethered tongue results from failure of the frenulum to recede during development. It is not known why this occurs. It is infrequently associated with certain syndromes such as Beckwith-Wiedemann syndrome.
What are the associated problems with tethered tongue?
Tethered tongue is usually an isolated condition. Depending on its severity, restriction of tongue movement can result in feeding and swallowing difficulties early on and speech difficulties later. It can sometimes be associated with a large tongue (or, macroglossia) in conditions such as Beckwith-Wiedemann syndrome.
Can a tethered tongue be inherited?
No specific genetic markers have been identified in tethered tongue deformity. However, the condition can run in families. Reporting of the condition is inconsistent, since many patients with subtle tethered tongue deformities may not even be recognized.
Most children with tethered tongues will not require surgery. Less than half may symptoms severe enough to warrant surgery. A “frenuloplasty” is performed under general anesthesia by cutting across the tether in a linear or zig-zag fashion. The final effect is to eliminate the tether and allow for greater tongue mobility. Sutures are absorbable and do not require removal. The surgery takes less than 30 minutes and can be done on an outpatient basis.
Recovery from tethered tongue release is relatively simple. Infants immediately return to bottle or breast feeding. In older children, a regular diet can be resumed. The sutures fall out on their own in 3 to 4 weeks. No other special precautions need to be taken.
Fortunately, complications from tethered tongue release (or, frenuloplasty) are rare. Typical surgical risks include bleeding, infection, or anesthesia complications. Scarring is negligible. The greatest risk is partial recurrence of the tether. This rarely requires correction.