International Journal of Physical Medicine & Rehabilitation
Open Access
ISSN: 2329-9096
ISSN: 2329-9096
Yasuo Ito*, Kazuaki Miyaguni, Tetsuro Sugihara, Go Kosugi, Nene Tookaichi, Myu Kaneko
Background: Severe ankyloglossia is generally assumed to be associated with poor preoperative articulation and delayed postoperative recovery. However, our previous study using word accuracy testing did not fully support this assumption. The present study aimed to clarify the relationship between the severity of ankyloglossia and postoperative prognosis using multiple articulation assessment methods.
Methods: A total of 74 children with ankyloglossia and speech disorders underwent preoperative assessment and lingual frenuloplasty under general anesthesia, followed by structured speech therapy. Articulation performance was assessed postoperatively at 1, 3, 6 and 12 months. For patients requiring rehabilitation longer than 12 months, evaluation was repeated at the completion of therapy. Assessment items included the number of correctly articulated words, types of articulation errors (omission, substitution, distortion), speech intelligibility and tongue mobility. Results were analyzed according to clinical subtype of ankyloglossia.
Results: Preoperative testing revealed significant differences (p<0.05) among subtypes. The tongue-tip type demonstrated fewer omissions compared with the anterior membrane type, and fewer substitutions compared with both the anterior membrane and tower types. Speech intelligibility was also significantly better in the tongue-tip type than in the anterior membrane type. Conversely, tongue mobility was significantly poorer in the tongue-tip type compared with the anterior membrane and tower types. Across the cohort, significant postoperative improvements (p<0.001) were observed in word test performance, substitution, distortion, speech intelligibility, and tongue mobility, with omission also improving less significantly (p<0.05).
Conclusion: Despite exhibiting the most severe restriction of tongue mobility, the tongue-tip type consistently showed superior articulation outcomes relative to other subtypes. This may be explained by compensatory articulation using posterior regions of the tongue. Future studies should include phoneme-specific analyses to elucidate these compensatory mechanisms.
Published Date: 2025-10-20; Received Date: 2025-09-21