Upper airway resistance syndrome (UARS) and obstructive sleep apnea (OSA) are related to the abnormal collapse of the upper airway during sleep. The key to a successful outcome of treatment is proper diagnosis to address the specific sites and patterns of airway obstruction. The lingual frenulum plays an important role in tongue mobility as well as for the development of maxillofacial skeleton, which in turn defines the foundation, dimensions, and patency of the nasal and oropharyngeal airway. This presentation explains the role of the restrictive lingual frenulum to perpetuate the following phenotypes of obstructive sleep apnea: (1) pediatric sleep-disordered breathing, (2) upper airway resistance syndrome, (3) and adult obstructive sleep apnea related to tongue base collapse and/or maxillary hypoplasia. The tongue range of motion ratio (TRMR) frenulum screening tool will be presented. Case studies will be presented to demonstrate surgical technique and to underscore the importance of pre- and post-operative myofunctional therapy in the care of these patients.
1) Recognize the relationship between the lingual frenulum, tongue mobility, and tongue base obstruction in upper airway resistance syndrome.
2) Use the tongue range of motion ratio as a screening tool for tongue-tie.
3) Explain the importance of myofunctional therapy as an essential component in optimizing the results of surgical treatment.