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Video

Sleep Medicine

(A1204) Assessing the Evidence Behind Lingual Frenulectomy for Sleep Apnea in Adults: A Scoping Review

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Emily R. Baker, MD

    Resident Physician
    Vanderbilt University Medical Center
    Memphis, Tennessee, United States

    • Co-Author(s)

  • Joseph M. Berry, MD

    Resident Physician
    University of Tennessee Health Science Center
    Memphis, TN, United States

    • Senior Author(s)

  • MG

    Marion B. Gillespie, MD, MSc

    Professor and Chair
    UTHSC
    Memphis, Tennessee, United States

Disclosure(s):
Emily R. Baker, MD: No relevant relationships to disclose.
Marion B. Gillespie, MD, MSc: No relevant relationships to disclose.


Introduction: There are numerous different well-established approaches to surgical treatment of obstructive sleep apnea (OSA), but frenuloplasty is not a currently recognized approach for most otolaryngologists who treat adults with OSA. However, there are many providers, primarily in the dentistry field, advertising this intervention to patients as a treatment for OSA. This study consists of a scoping review of the primary literature covering this topic and an examination of practice patterns by US providers.

Methods: 4 databases (PubMed, Cochrane, Scopus, Embase) were searched through December 2024 for studies that address the use of frenuloplasty for OSA in adults. Examples of included search terms include “ankyloglossia,” “frenulectomy,” “frenuloplasty,” “tongue tie release,” and “frenotomy.”

Results: Of the 84 studies screened, only 3 studies included adults with OSA who underwent frenuloplasty, and only one study included data from pre- and postoperative polysomnography. The mean apnea-hypopnea index (AHI) of the 7 patients included in this study increased from 17.3 ± 9.4 to 27.7 ± 14.0 following frenuloplasty. One study compared drug-induced sleep endoscopy (DISE) findings before and after frenuloplasty in 3 patients and reported partial improvement in anteroposterior collapse at the level of the base of tongue in 2 patients but provided no other outcome measures. The remaining study contained 203 adult patients and presented all results in the form of patient-reported outcome measures. A search for practitioners offering this procedure revealed there is a wide network of clinicians advertising this intervention to patients. An online directory run by one of the major proponents of this therapy contains information for 577 practices who follow this school of thought.

Conclusions: Despite the lack of quality evidence, there are many clinicians offering frenuloplasty to patients as a treatment for obstructive sleep apnea. It is important that otolaryngologists be aware of this practice when counseling patients who are seeking out alternative treatments for OSA.