Speech Therapy Assessment in Children with Cleft Lip and Palate and Short Lingual Frenulum: Case Report

Introduction: Evidences suggesting that a short lingual frenulum is a genetic abnormality strictly related to cleft palates. This aspect shows the need for a thorough assessment of these subjects with cleft, verifying the alteration found, as well as possible therapeutic and/or surgical indication.

Objectives: To relate a speech therapy assessment case of a child with cleft lip and palate and short lingual frenulum.

Resumed report: A male child, eight years old, with cleft lip and palate was referred by the plastic surgery department for speech-language therapy. After the speech therapy assessment, incisive transforaminal cleft bilateral, with fistulae in the anterior palate, and with sensitivity and tone-appropriate oral facial structures were identified. It is an appropriate clinical exam of structural mobility, except for the tongue, which showed difficulty in performing lateralization, elevation, and vibration movements, noticing the need for lingual frenulum assessment. Therefore, the Lingual Frenulum Evaluation Protocol was applied, resulting on score 6 (best result: 0; worst result: 8) on general evaluation, considering the frenulum as altered. On the functional evaluations, obtained score 25, on which the best is 0 and the worst is 40, suggesting a possible interference on the functionality because of the lingual frenulum.

Conclusion: Besides presenting incisive transforamen cleft lip and palate, the child also has short lingual frenulum, which interferes on the patient’s tongue functionality. It is noticed, in this case, the importance of a speech therapy assessment, which can adapt therapy to the cleft and frenulum deficits, as well as return to the plastic surgery department the alteration found, suggesting possible correction.

Keywords: speech-language therapy, cleft lip and palate, short lingual frenulum.