Intervenção fonoaudiológica miofuncional no pós-operatório de frenectomia lingual em bebês - série de casos

Abstract

Introduction: Ankyloglossia, characterized by an anatomical alteration of the lingual frenulum, can negatively affect breastfeeding and orofacial functions such as sucking, swallowing, chewing, and speech. In Brazil, the mandatory implementation of the "Teste da Linguinha" (Lingual Test), established by Law No. 13,002/2014, has been fundamental for early diagnosis, although its application remains limited in some regions. Interventions such as frenectomy, combined with orofacial myofunctional therapy (OMT), have proven effective in improving oral functions and preventing complications like fibrosis and postoperative adhesions. Objective: To compare the functional and anatomical outcomes of myofunctional speech therapy intervention performed pre- and postoperatively in lingual frenectomy for infants. Materials and methods: This is an observational and analytical case series study involving infants aged 0 to 4 months, exclusively breastfed, diagnosed with ankyloglossia, and referred for frenectomy. Families were invited to participate, and an Informed Consent Form (ICF) explaining the procedures was provided. Seventy-two hours after surgery, the infants received direct OMT on the tongue, without manipulating the surgical wound, for four weeks. Caregivers were trained to perform the exercises at home three times daily, following biosafety guidelines. Thirty days after the last session, the infants were reassessed using the initial protocol. Those with unsatisfactory healing or functional impact were referred for further surgical intervention. Results: A total of 114 infants were evaluated, of which 65 were diagnosed with ankyloglossia and referred for frenectomy. In the intervention group, 20 infants were selected, but only 12 met all inclusion criteria and were analyzed. The initial evaluation using the Martinelli Protocol showed a median score of 13.5 (Q1=13, Q3=14.75), which decreased to 8 (Q1=7.25, Q3=9.75) after the intervention (P=0.002). No cases of fibrosis or re-adhesion were observed, and no infant scored above 10 during reassessment. The results demonstrated a significant improvement in breastfeeding complaints, particularly a 66.7% reduction in nutritive sucking incoordination. Conclusion: Oral Myofunctional Therapy (OMT) has proven effective in orofacial rehabilitation post-frenectomy, improving tongue mobility and strength while optimizing functions such as sucking and swallowing, benefiting breastfeeding. The findings suggest that OMT supports the recovery of stomatognathic functions and promotes an adequate healing process.