Effects of Behavioural and Prosthetic Management in a Case with Ankyloglossia and High Arched Palate: Pre and Post Operative Comparison
DOI:
https://doi.org/10.12970/2311-1917.2015.03.02.1Keywords:
Ankyloglossia, High-arched Palate, Frenectomy, Behavioral Management, Prosthetic Management.Abstract
Purpose: This single subject research design across multiple treatments was aimed towards determining the efficacy of behavioral and prosthetic management in congenital ankyloglossia class IV and high arched palate; pre and post lingual frenectomy.
Method: The study was conducted over four phases: two pre operative and two post operative. The first phase was started with behavioral management solely followed by the second phase, where a combination of behavioral and prosthetic management simultaneously, was tried out. The participant then underwent lingual frenectomy. Post operatively, the third phase was initiated with a combinatorial use of behavioral and prosthetic management. However noticing the simultaneous improvement in the range of motion of tongue, a fourth trial phase was conducted, by seizing the prosthetic management and continuing only with the behavioral management.
Results: The first two pre operative trial phases resulted in an insignificant shift in percentage of correct consonants (PCC) from 68.59% to 70.93%. However the post operative phases yielded interesting results. Although in the third phase the PCC shifted to 72.7%, but a remarkable improvement was visible in the fourth phase of the study, as the PCC shifted to 84.57%.
Conclusion: The results highlighted that in such classical cases, professionals should shed their dilemma of whether to clip the tie or not? This decision will actually help in reducing the unnecessary clinical trials along with better prognosis of client’s speech.
References
Tongue [Internet]. Medical Dictionary for the Dental Professions; 2012. [cited 2013 June 19]. Available from http://medical-dictionary.thefreedictionary.com/tongue
Speech Sound Structures [Internet]. David Newmonic Language Resources; 2013-2016. [updated 2011 August; cited 2013 Dec 9]. Available from http://www.speech-language-resources.com/speech-sound-structures.html
Hard Palate [Internet]. 2014 September. [updated 2015 May 19; cited 2015 June 5]. Available from https://en.wikipedia. org/?title=Hard_palate
Johnson PRV. Tongue-tie – exploding the myths. Infant 2006; 2(3): 96-99.
Fernando C. Tongue Tie - From Confusion to Clarity: A Guide to the Diagnosis and Treatment of Ankyloglossia. Sydney: Tandem Publications: 1998.
Friend GW, Harris EF, Mincer HH, et al. Oral anomalies in the neonate, by race and gender, in an urban setting. Pediatr Dent 1990; 12: 157-61.
Emmanouil-Nikoloussi EN, Kerameos-Foroglou CH. Congenital syndromes connected with tongue malformations. Bull Assoc Anat 1992; 76: 67-72.
Kotlow LA. Ankyloglossia (tongue – tie): a diagnostic and treatment quandary. Quintessence Int 1999; 30: 259-62.
Kummer AW. Ankyloglossia: To clip or not to clip? That’s the Question. The ASHA Leader 2005; 10(17): 6-7, 30.
Wallace AF. Tongue-tie. Lancet 1963; 2: 377-8. http://dx.doi.org/10.1016/S0140-6736(63)93057-5
Catlin FI, De Hann V. Tongue-tie. Arch Otolaryngology 1971; 94: 548-57. http://dx.doi.org/10.1001/archotol.1971.00770070848010
Williams WN, Waldron CM. Assessment of lingual function when ankyloglossia (tongue-tie) is suspected. J Am Dent Assoc 1985; 110: 353-6. http://dx.doi.org/10.14219/jada.archive.1985.0328
Horton CE, Crawford HH, Adamson JE, et al. Tongue-tie. Cleft Palate J 1969; 6: 8-23.
Messner AH, Lalakea ML. The effect of ankyloglossia on speech in children. Otolaryngol Head Neck Surg 2002; 127: 539-45. http://dx.doi.org/10.1067/mhn.2002.129731
Lalakea ML, Messner AH. Ankyloglossia: does it matter?. Pediatr Clin North Am 2003; 50: 381-397. http://dx.doi.org/10.1016/S0031-3955(03)00029-4
Hindi - Photo Articulation Test: H-PAT. Ali Yavar Jung National Institute for the Hearing Handicapped and Regional Rehabilitation Training Centre Madras. UNICEF sponsored project: India 2004.
Shriberg LD, Kwiatkowski J. Phonological disorders III: a procedure for assessing severity of involvement. Journal of Speech and Hearing Disorders 1982; 47(3): 256-70. http://dx.doi.org/10.1044/jshd.4703.256
McEnery ET, Gaines FP. Tongue-tie in infants and children. Journal of Pediatrics 1941; 18: 252-5. http://dx.doi.org/10.1016/S0022-3476(41)80174-7
Messner AH, Lalakea ML. Ankyloglossia: controversies in management. International Journal of Pediatric Otorhinolaryngol 2000; 54: 123-31. http://dx.doi.org/10.1016/S0165-5876(00)00359-1
Peterson-Falzone SJ, Hardin-Jones MA, Karnell MP. Cleft Palate Speech. 3rd ed. St. Louis, MO: Mosby Elsevier 2001.