Tongue-tie (ankyloglossia) is a common congenital anomaly in children with incidence of 4.8% of live births. With tongue-tie, an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue's tip to the floor of the mouth, so it may interfere with breast-feeding, speech, eating, swallowing. The standard surgical treatment offered to this congenital anomaly is Frenotomy operation. I describe a new and unique surgical treatment option for this anomaly which

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... described for the first time in medical literature. Materials and Methods: In last 3 years in Jawale Institute of pediatric surgery, I did 21 cases of Tongue Tie release operation (Frenotomy) with methylene blue dye induced infrared laser cutting technique (Group A). 26 patients during same period were put as control (Group B) where the Frenotomy operation was done with conventional technique with electrocautery. Results: In group A, 1(4.76%) patient complained difficulty in eating and swallowing, 2 patients (9.52%) had pain postoperatively for more than 48 hours. No patient had edema of tongue. There was no postoperative bleeding. In Group B, 6(23.07%) patients complained difficulty in eating and swallowing, 12(46.15%) patients had pain postoperatively for more than 48 hours. 6 (23.07%) patients had edema of tongue and 2(7.69%) patients had mild oozing of blood after 48 hours. Conventionally, frenotomy is performed under general anesthesia with cutting type of electrocautery to lengthen the tongue till it comfortably comes out of mouth. In my technique of Tongue tie release operation (Frenotomy) is done by injecting methylene blue dye into frenulum and cutting it by infrared laser of 950 nm and 20 Watt in power. Methylene blue has the opposite color of infrared, hence maximum absorption and cutting occurs. Discussion: In The advantages of this technique over the conventional are as follows. The operation is blood less as the infrared laser of 950 nm has a much better coagulation power compared to the electrocautery. As the laser is quite precise, the collateral damage produced by laser is much lower compared to electrocautery. Because of the Methylene blue dye a cheap infrared laser (USD 500) can be used for this purpose. Otherwise, a high frequency 2000 nm and high wattage (40 Watt) laser has to be used which is extremely costly (USD 50,000) and is not affordable to most surgeons. Methylene blue as a dye that is already FDA approved to be used topically as well as intravenously in human body. Hence there are no ethical issues for using it on human body. This new and unique surgical treatment option for this anomaly which is described for the first time in medical literature. Conclusions: The Tongue tie release operation (Frenotomy) by methylene blue dye induced infrared laser is a safe, effective and affordable technique. The technique can be used on plenty of other operations in surgery.