International Journal of Orofacial Myology and Myofunctional Therapy

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Purpose: Ankyloglossia (tongue-tie) can lead to oromyofascial dysfunction which affects breathing, swallowing, speech, and posture. This study presents the evolution and outcomes of a refined lingual frenuloplasty protocol that integrates individualized myofunctional therapy to address compensatory patterns. Methods: A prospective cohort of 445 patients (≥4 years) was treated between 2021 and 2023 using a fascia-preserving CO₂ laser protocol with structured pre- and postoperative myofunctional therapy. Patients were stratified as pediatric (<12 years) or adolescent/adult (≥12 years). Key refinements included fascia-sparing dissection, reduced suture tension with cyanoacrylate adhesive, defined functional endpoints, structured myofunctional therapy, and standardized wound-healing strategies. Results: Among 379 patients (85% response) with >2 months follow-up, the 2025 protocol achieved an 86% satisfaction rate and significantly fewer complications compared with 2019 (pain 3.7% vs. 15.8%; bleeding 1% vs. 13%; revision 2.1% vs. 6.6%). Deeper genioglossus dissection increased swelling risk (OR = 4.0, p < 0.0001) but did not affect satisfaction. Conclusions: The refined 2025 protocol represents an outcome-tracked advancement in ankyloglossia management. By emphasizing fascia preservation, functional diagnostics, and integrated myofunctional therapy, the approach improves safety, efficacy, and patient-centered outcomes.

Background: Orofacial myofunctional therapy (OMT) is frequently applied to correct atypical swallowing, yet its therapeutic strategies remain heterogeneous and poorly standardized. Objective: This scoping review aimed to characterize the strategies described in the literature for OMT in individuals diagnosed with atypical swallowing. Methods: Following Joanna Briggs Institute and PRISMA-ScR guidelines, and with a registered protocol, we included clinical and experimental studies without age restriction, conducted in clinical or research contexts. Studies were retrieved from PubMed, EMBASE, and Cochrane Library using MeSH terms and specific keywords. Data were extracted using a standardized form and summarized descriptively. Results: Twelve studies published between 1989 and 2024, involving 164 participants aged 5–26 years, were included. Interventions were mainly performed by speech-language pathologists in pediatric and adolescent populations, combining tongue posture exercises, muscle strengthening, orofacial mobility, and functional swallowing training. Treatment duration ranged from 8 weeks to 6 months, with weekly sessions and home practice recommendations. In 83% of studies, improvements in swallowing patterns and tongue posture were reported, especially when combined with orthodontic treatment. Conclusions: OMT is characterized as a multifactorial intervention integrating muscle training and functional re-education, but variability in protocols and lack of standardization limit clinical comparability. Future multicenter studies with greater methodological control are needed.