Surface Electromyographic Analysis of the Suprahyoid Muscles in Infants Based on Lingual Frenulum Attachment during Breastfeeding.

Muscle electrical activity analysis can aid in the identification of oral motor dysfunctions, such as those resulting from an altered lingual frenulum, which consequently impairs feeding. Here, we aim to analyze the suprahyoid muscle electrical activity of infants via surface electromyography, based on lingual frenulum attachment to the sublingual aspect of the tongue and floor of the mouth during breastfeeding. In the present study, we have studied full-term infants of both genders, aged between 1 and 4 months old. The mean muscle activities were recorded in microvolts and converted into percent values of the reference value. Associations between the root mean square and independent variables were tested by one-way analysis of variance and Student's t-test, with a significance level of 5% and test power of 95%, respectively. We evaluated 235 infants. Lower mean muscle electrical activity was observed with the lingual frenulum attached to apex/lower alveolar ridge, followed by attachment to the middle third/lower alveolar ridge, and between the middle third and apex/lower alveolar ridge. Greater suprahyoid muscle activity was observed with lingual frenulum attachment to the middle third of the tongue/sublingual caruncles, showing a coordination between swallowing, sucking, and breathing. Surface electromyography is effective in diagnosing lingual frenulum alterations, the attachment points of which raises doubt concerning the restriction of tongue mobility. Thus, it is possible to identify oral motor dysfunctions.

Classificação anatômica do frênulo lingual de bebês / Anatomical classification of lingual frenulum in babies

RESUMO Objetivo: analisar os aspectos anatômicos do frênulo lingual de bebês atendidos no Centro de Referência em Saúde Auditiva / CRESA da Pontifícia Universidade Católica de Goiás / PUC Goiás. Métodos: trata-se de um estudo transversal, observacional, analítico, com abordagem quantitativa. Foram avaliados bebês entre 1 e 4 meses, de ambos os gêneros, alimentados no seio materno, sendo excluídos bebês com alterações anatomofisiológicas na face, pré ou pós maturidade ou com comprometimento neurológico. Para a classificação anatômica do frênulo lingual foram analisadas a espessura do frênulo e a sua fixação na língua e no assoalho da boca, a partir do "Protocolo de avaliação do frênulo da língua com escores para bebês" (MARTINELLI; MARCHESAN; BERRETIN-FELIX, 2013). Resultados: foi possível visualizar o frênulo em 165 bebês, sendo 104 normais e 61 alterados. Em apenas 1 bebê não foi possível visualizar o frênulo. Dentre os frênulos normais, predominou os com fixação no terço médio e visível a partir das carúnculas sublinguais. Dos frênulos alterados foi mais frequente aqueles com fixação entre o terço médio e o ápice e visível a partir da crista alveolar inferior. Predominou a espessura delgada. Dos bebês com frênulo alterado, 24 apresentaram sucção alterada e, com frênulo normal, 18 apresentaram sucção alterada. Conclusão: os frênulos linguais foram classificados em normal e alterado, sendo predominante o frênulo lingual normal e a espessura delgada. A alteração do frênulo prevaleceu no gênero masculino. Bebês com frênulo lingual alterado apresentaram mais chances de alteração na sucção, embora a correlação entre frênulo e sucção tenha sido baixa.

ABSTRACT Purpose: to analyze the anatomical aspects of the lingual frenulum of babies attended the Reference Center for Hearing Health / CRESA, of the Pontifical Catholic University of Goiás / PUC Goiás. Methods: it is a cross-sectional, observational, analytical study with a quantitative approach. Babies between 1 and 4 months, of both genders, fed in the womb, were evaluated; babies with anatomical and physiological changes in the face, pre or post maturity or neurological impairment were excluded. For the anatomical classification of the lingual frenulum were analyzed the thickness of the frenulum and its attachment on the tongue and mouth floor, from the "Lingual frenulum protocol with scores for infants" (MARTINELLI; MARCHESAN; BERRETIN-FELIX, 2013). Results: it was possible to view the frenulum in 165 babies, being 104 normal and 61 altered. In just one baby was not possible to see the frenulum. Among the normal frenulum, were prevalent those with the attachment in the middle third and visible from the sublingual caruncles. Among the altered frenulum was more frequent those with attachment between the middle third and the apex and visible from inferior alveolar crest. Thin thickness was predominant. Among the babies with altered frenulum, 24 had altered suction and, of the babies with normal frenulum 18 had altered suction. Conclusion: the lingual frenulum were classified as normal or altered, being predominant normal lingual frenulum and thin thickness. Altered frenulum was prevalent in males. Babies with altered lingual frenulum showed more change of alteration in suction, although the correlation between frenulum and suction was low.