Frenulotomy & Frenulectomy for Ankyloglossia (Tongue Tie)
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2025-03-03
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Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery
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University of Cape Town
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Abstract
Frenulotomy (also referred to as frenotomy) and frenulectomy (frenectomy) are surgical procedures to correct ankyloglossia, a congenital condition in which the lingual frenulum is too short, causing restricted tongue movement. It is commonly called “tongue tie” and affects 4-11% of neonates. Frenulotomy refers to an incision in the frenulum that frees the tongue from the floor of the mouth. Frenulectomy refers to complete excision of a frenulum. It is more invasive and may be difficult to perform on small children; however, the results are more predictable, and recurrence rates are lower. The tongue is attached to the floor of the mouth by a lingual frenulum. A normal frenulum’s appearance varies considerably between individuals. Microdissection of cadavers shows that it is a dynamic, layered structure formed by oral mucosa and underlying floor of mouth fascia, which is mobilised into a midline fold with tongue elevation and/or retraction. The base of the frenulum contains a "V" shaped hump of tissue which houses the two Wharton’s ducts on either side (Figure 1). The sub-lingual salivary glands empty through tiny ducts on either side of Wharton's ducts. Superficial veins, known as ranine veins, run through the base of the frenulum (Figure 1).
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Reference:
Diale, N., Peer, S. & McGuire, J. 2025. Frenulotomy & Frenulectomy for Ankyloglossia (Tongue Tie). In Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery. J. Fagan, Ed.Cape Town, South Africa: University of Cape Town. 8. http://hdl.handle.net/11427/43549 .