Revista CEFAC
https://revistacefac.org.br/article/doi/10.1590/1982-0216/202426213123
Revista CEFAC
Relatos de Casos

Clinical and electromyographic evaluation pre and post lingual frenotomy of an infant with ankyloglossia: A case report

Avaliação clínica e eletromiográfica de bebê com anquiloglossia pré e pós-frenotomia lingual: relato de caso

Daniele Fontes Ferreira Bernardes; Viviane Veroni Degan; Giédre Berretin-Felix

Downloads: 0
Views: 91

Abstract

The goal is to present a clinical case of a baby diagnosed with ankyloglossia evaluated clinically and by surface electromyography, during bottle sucking before and after 15, 30 and 60 days of lingual frenotomy. Based on the anatomofunctional evaluation of the Tongue Frenulum Assessment Protocol in Babies, interference of the lingual frenulum was identified. The tongue, during sleep, was positioned on the floor of the mouth. The initial electromyographic evaluation of the suprahyoid muscles, during bottle feeding, showed asymmetry in root mean square (RMS) values, in microvolts (μV), between the right and left suprahyoid muscles. The evaluation was repeated after 15, 30 and 60 days after lingual frenotomy. After 15 days, appropriate lip and tongue posture, coordinated sucking movements, and absence of noises or choking were observed. After 30 days, symmetry was observed between the suprahyoid muscles, which was maintained 60 days after the surgical procedure. After lingual frenotomy, the adequacy of the position of lips and tongue, during rest and sleep, was reestablished within 15 days, and after 30 days of the procedure, there was adequacy of the tongue posture, during crying, and symmetry of the electromyographic activity of the suprahyoid muscles, during sucking. The results were maintained until the end of the study.

Keywords

Ankyloglossia; Lingual Frenulum; Suction; Electromyography

Resumo

O objetivo é apresentar um caso clínico de um bebê diagnosticado com anquiloglossia, avaliado clinicamente e por eletromiografia de superfície na sucção de mamadeira antes e após 15, 30 e 60 dias da frenotomia lingual. Baseado na avaliação anatomofuncional do Protocolo de Avaliação do Frênulo da Língua em Bebês, identificou-se interferência do frênulo lingual. A língua, durante o sono, apresentava-se no assoalho da boca. A avaliação eletromiográfica inicial dos músculos supra-hioideos, na sucção por mamadeira, mostrou assimetria no root mean square (RMS), em microvolts (μV), entre os músculos supra-hioideos direitos e esquerdos. A avaliação foi repetida após 15, 30 e 60 dias da frenotomia lingual. Após 15 dias observaram-se postura de lábio e língua adequadas, sucção com movimentos coordenados, ausência de ruídos ou engasgos. Após 30 dias observou-se simetria entre os músculos supra-hioideos, que se manteve 60 dias após o procedimento cirúrgico. Após a frenotomia lingual, a adequação da posição de lábios e língua, durante repouso e sono, foram restabelecidas em 15 dias, e, após 30 dias do procedimento, ocorreu adequação da postura de língua no choro e simetria da atividade eletromiográfica dos músculos supra-hioideos na sucção. Os resultados foram mantidos até o fim do estudo.

Palavras-chave

Anquiloglossia; Freio Lingual; Sucção; Eletromiografia

Referências

1. Mills N, Keough N, Geddes DT, Pransky SM, Mirjalili SA. Defining the anatomy of the neonatal lingual frenulum. Clin Anat. 2019;32(6):824-835. https://doi.org/10.1002/ca.23410 PMID: 31116462.

2. Martinelli RL de C, Marchesan IQ, Berretin-Felix G. Longitudinal study of the anatomical characteristics of the lingual frenulum and comparison to literature. Rev. CEFAC. 2014;16(4):1202-7. https://doi.org/10.1590/1982-021620149913

3. Martinelli RL de C, Queiroz Marchesan I, Jordão Gusmão R, Castro Rodrigues A de, Berretin-Felix G. Histological characteristics of altered human lingual frenulum. Int J Pediatr Child Heal. 2014b;2(1):5-9. http://dx.doi.org/10.12974/2311-8687.2014.02.01.2

4. Campanha SMA, de Castro Martinelli RL, Palhares DB. Position of lips and tongue in rest in newborns with and without ankyloglossia. CoDAS. 2021;33(6):1-5. https://doi.org/10.1590/2317-1782/20202020069 PMID: 34190809.

5. Costa-Romero M, Espínola-Docio B, Paricio-Talayero JM, Díaz-Gómez NM. Anquiloglosia en el lactante amamantado. Puesta al día. Arch Argent Pediatr 2021;119(6):e600-e609. http://dx.doi.org/10.5546/aap.2021.e600

6. Martinelli RLC, Marchesan IQ, Gusmão RJ, Berretin-Felix G. Effect of lingual frenotomy on tongue and lip rest position: A nonrandomized clinical trial. Int Arch Otorhinolaryngol. 2022;26(1):E69-74. https://doi.org/10.1055/s-0041-1726050

7. Ghaheri BA, Cole M, Fausel SC, Chuop M, Mace JC. Breastfeeding improvement following tongue-tie and lip-tie release: A prospective cohort study. Laryngoscope. 2017;127(5):1217-23. https://doi.org/10.1002/lary.26306

8. Campanha SMA, Martinelli RL de C, Palhares DB. Association between ankyloglossia and breastfeeding. CoDAS. 2019;31(1):1-7. https://doi.org/10.1590/2317-1782/20182018264 PMID: 30810632.

9. França ECL, Albuquerque LCA, Martinelli R de CL, Gonçalves IMF, Souza CB, Barbosa MA. Surface electromyographic analysis of the suprahyoid muscles in infants based on lingual frenulum attachment during breastfeeding. Int J Env Res Public Heal. 2020;30(17):859. https://doi.org/10.3390/ijerph17030859

10. Martinelli R de CL, Marchesan IQ, Gusmão RJ, Honório HM, Berretin-Felix G. The effects of frenotomy on breastfeeding. J Appl Oral Sci. 2015;23(2):153-7. https://doi.org/10.1590/1678-775720140339 PMID: 26018306. PMCID: PMC4428459.

11. Messner AH, Walsh J, Rosenfeld RM, Schwartz SR, Ishman SL, Baldassari C et al. Clinical Consensus Statement: Ankyloglossia in Children. Otolaryngol - Head Neck Surg (United States). 2020;162(5):597-611. https://doi.org/10.1177/0194599820915457

12. França ECL, Albuquerque LCA, Martinelli RLC, Gonçalves IMF, Souza CB, Barbosa MA. Surface electromyographic analysis of the suprahyoid muscles in infants based on lingual frenulum attachment during breastfeeding. Int J Environ Res Public Health. 2020;17(3):859. https://doi.org/10.3390/ijerph17030859 PMID: 32019082. PMCID: PMC7037214.

13. Martinelli RLC, Marchesan IQ, Lauris JR, Honório HM, Gusmão RJ, Berretin-Felix G. Validation of the Lingual Frenulum Protocol for Infants. Int J Orofacial Myology. 2016;42(1):6-14. https://doi.org/10.52010/ijom.2016.42.1.1

14. Martinelli RLC, Marchesan IQ, Lauris JR, Honório HM, Gusmão RJ, Berretin-Felix G. Validade e confiabilidade da triagem: "teste da linguinha". Rev. CEFAC. 2016;18(6):1323-31. https://doi.org/10.1590/1982-021620161868716

15. Armijo-Olivo S, Gadotti I, Kornerup M, Lagravère MO, Flores-Mir C. Quality of reporting masticatory muscle electromyography in 2004: A systematic review. J Oral Rehabil. 2007;34(6):397-405. https://doi.org/10.1111/j.1365-2842.2007.01706.x PMID: 17518973.

16. Berry J, Griffiths M, Westcott C. A double-blind, randomized, controlled trial of tongue-tie division and its immediate effect on breastfeeding. Breastfeed Med. 2012;7(3):189-93. https://doi.org/10.1089/bfm.2011.0030 PMID: 21999476.

17. Martinelli RLC, Marchesan IQ, Honário HM, Berretin-Félix G. Relação entre frênulo lingual e tendência do posicionamento da língua durante o choro em bebês. 2016, Anais. São Paulo: Sociedade Brasileira de Fonoaudiologia, 2016. Access on: nov 7, 2023.

18. Fraga M do RB de A, Barreto KA, Lira TCB, Celerino PRRP, Tavares IT da S, Menezes VA de. Ankyloglossia and breastfeeding: What is the evidence of association between them? Rev. CEFAC. 2020;22(3):e12219. https://doi.org/10.1590/1982-0216/202022312219

19. Bussi MT, Corrêa CC, Cassettari AJ, Giacomin LT, Faria AC, Moreira APSM et al. Is ankyloglossia associated with obstructive sleep apnea? Braz J Otorhinolaryngol. 2022;88 Suppl 1(Suppl 1): S156-S162. https://doi.org/10.1016/j.bjorl.2021.09.008 PMID: 34895868; PMCID: PMC9734261.

20. Araujo MDCM, Freitas RL, Lima MGS, Kozmhinsky VMDR, Guerra CA, Lima GMS et al. Evaluation of the lingual frenulum in newborns using two protocols and its association with breastfeeding. J Pediatr. 2020;96(3):379-85. https://doi.org/10.1016/j.jped.2018.12.013 PMID: 31029684. PMCID: PMC9432008.

21. Walsh J, Tunkel D. Diagnosis and treatment of ankyloglossia in newborns and infants: A review. JAMA Otolaryngol Head Neck Surg. 2017;143(10):1032-9. https://doi.org/10.1001/jamaoto.2017.0948 PMID: 28715533.

22. Billington J, Yardley I, Upadhyaya M. Long-term efficacy of a tongue tie service in improving breastfeeding rates: A prospective study. J Pediatr Surg. 2018;53(2):286-8. https://doi.org/10.1016/j.jpedsurg.2017.11.014 PMID: 29248165.
 


Submetido em:
05/12/2023

Aceito em:
18/06/2024

66fea097a9539510cf461cb2 cefac Articles

Revista CEFAC

Share this page
Page Sections