Frenotomy Provides Improved Direct Laryngoscopy Exposure in Select Adult Patients With Ankyloglossia.
Gustavo A Marino, C Gaelyn Garrett, Alan D Tate
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Case in brief
Two adults with restrictive ankyloglossia and a history of suboptimal true vocal fold exposure during direct laryngoscopy for phonomicrosurgery had limited tongue protrusion. Attempts to improve exposure with manual tongue protrusion remained inadequate; neither patient had mandibular tori. Intraoperative lingual frenotomy followed by manual tongue protrusion substantially improved direct laryngoscopy exposure, allowing considerably more visualization of the anterior true vocal folds.
What made this case unusual
Ankyloglossia was identified as a potentially remediable contributor to difficult laryngeal exposure in adults undergoing phonomicrosurgery.
Diagnostic / clinical pearl
When tongue restriction accompanies inadequate direct laryngoscopy exposure despite manual protrusion, assess for restrictive ankyloglossia; frenotomy improved anterior vocal fold visualization in these patients.