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February 2004
By Youn W. Park, MD, and Mark Matthews,
MD
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CASE:
A three-year-old boy is brought in by his mother for evaluation
of a tongue deformity. The lingual frenulum is short and thickened
and the tongue is notched at the tip. The mother wonders whether
her son's speech problem is related to this condition.
WHAT IS YOUR DIAGNOSIS?
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Ankyloglossia (tongue-tie) is a tongue deformity in which the
lingual frenulum appears abnormally short and thick, and in
extreme cases, causes a fusion of the tongue to the anterior
floor of the mouth. Reported incidence of the deformity is more
than 1%. The defect probably results from disruption of the
formation of the oral vestibule by an ingrowth of ectoderm.
Parents often blame it for articulation disorders, but its actual
interference with speech development is reportedly rare. If
the child can protrude the tongue to the incisor teeth, lingual
function for speech probably will not be affected. In the absence
of major difficulty with sucking, treatment is usually not indicated
before age four, considering the possibilities of bleeding,
infection, and scar formation. |
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Dr. Park is a clinical professor of otolaryngology
at Northeastern Ohio Universities College of Medicine and
section head of otolaryngology at Barberton Citizens Hospital
in Barberton, Ohio. Dr. Matthews is an attending physician
in the department of family practice at Akron General Medical
Center in Akron, Ohio.
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