case_images: PMC6437727_01
case_images: Patient sleeping with open mouth posture, noisy breathing, and incomplete lip seal (see complete video at https://tinyurl.com/Figure1Video).
case_images: CRIOT2019-3408053.001.jpg
case_images: PMC6437727_01_CRIOT2019-3408053.001.jpg
case_images: fig1
case_images: With respect to sleep, there were reports of difficulties going to sleep, waking up two to three times per night to drink water, getting up to go to the bathroom, open mouth breathing while asleep (Figure 1), snoring during sleep, and sweating more than usual during sleep.
case_images: Lingual frenulum at time of physical exam, preoperative.
case_images: CRIOT2019-3408053.002.jpg
case_images: PMC6437727_01_CRIOT2019-3408053.002.jpg
case_images: fig2
case_images: Physical examination (Figure 2) of the patient showed her to be well developed, well nourished, and to appear the stated age.
case_images: (a) Labial frenulum, preoperative. (b) Lingual frenulum, preoperative. (c) Labial frenulum, postoperative. (d) Lingual frenulum, postoperative.
case_images: CRIOT2019-3408053.003.jpg
case_images: PMC6437727_01_CRIOT2019-3408053.003.jpg
case_images: fig3
case_images: The patient was found to have a restrictive class 2 upper labial frenulum with tethering of the upper lip (Figure 3(a)) and restrictive grade 4 lingual frenulum (Figure 3(b)). A V-to-Y lip closure was performed with a 4-0 chromic suture applied in a simple interrupted fashion (Figure 3(c)). In total, the tongue was released from a grade 4 restricted range of motion to a grade 1 range of motion (Figure 3(d)).
case_images: Patient sleeping with closed mouth posture and exclusive nasal breathing (see complete video at https://tinyurl.com/Figure4Video).
case_images: CRIOT2019-3408053.004.jpg
case_images: PMC6437727_01_CRIOT2019-3408053.004.jpg
case_images: fig4
case_images: By the fourth day after surgery, the patient exhibited closed-mouth nasal breathing while asleep (Figure 4).
case_images: Lingual frenulum, 2 months postop.
case_images: CRIOT2019-3408053.005.jpg
case_images: PMC6437727_01_CRIOT2019-3408053.005.jpg
case_images: fig5
case_images: Grade 1 tongue range of motion was observed (Figure 5).