211 FRENULOPLASTY - RELEASE TONGUE TIE

can be done alone, or at time of other cleft procedure such as cleft palate repair.

updated January 12, 2013

 

OPERATIVE TIME: 1 hour

USUAL LOCATION(S): Pres Day or Main

FREQUENCY: 10/year

ASSISTANT: No

ICD9 CODES:

141.3 LINGUA FRENULUM

CPT CODE(S):

41520FRENULOPLASTY WITH Z PLASTY

 

ANESTHESIA NOTES

●regular ET tube (no RAE)

●Dr. C to start IV and sew in tube with 2-0 silk

●temp probe

●Kefzol IV 25mg/kg

PATIENT POSITION | SETUP

■TABLE IS NOT TURNED when done alone

■Dr. C to suture tube with 2-0 silk SH, needle holder, scissors

■Rolled terrycloth towel under shoulders

■Large round gel doughnut under head

■Pedi Baer hugger, blanket

TABLE POSITION

Lower foot, close head gap, DO NOT REMOVE HEAD PIECE.

Large round gel donut head rest.

ROOM SETUP

Warm room 72o, warm bed and head rest w/ Baer

Separate mayo stand for video equip

 

EQUIPMENT and SPECIALS

■Light source w/ headlight

■Baer hugger

SPECIALS

None

PREP

Technicare with minimal water, cotton tip applicators to clean nose, wipe inside mouth, lightly over eyelids

DRAPING and PACKS

Cleft Palate Custom Pack, Towel Pack

Head sheet (two green towels and a ¾ sheet), ¾ sheet, magnetic pad, rigid box for bovie, towel clips, ½” steri-strip for eyes, 1000 drape, 2" Kling for pharyngeal pack

CAUTERY

Bovie 8/8 pure, [1]Colorado tip,

[1] Megadyne 0118a 2½" needle tip, holster

SUCTION

single with 7fr Frazier tip, 10fr NG suction catheter at end

 

SOLUTIONS | IRRIGATION

Kefzol irrigation 500mg/500cc NS, 30cc syringe with 14g angiocath, saline, water

NEEDLES | SYRINGES

[2] 3cc syringe, [1] 30cc syringe,

[4] 30g needle 5/8", [1]12g angiocath

LOCAL ANESTHETIC

peds mixture: 50/50 - In 3cc syringe with 30g needle x 2

■ 1% lidocaine w/ epi 1:100,000 +

■ 0.5% Ropivicaine plain

MEDICATIONS

■Kefzol for irrigation

■Bacitracin ointment

211 FRENULOPLASTY - RELEASE TONGUE TIE

page 2

 

SETS TO OPEN Dr. C Cleft Lip / Fine Instrument Set

INSTRUMENTS USED (ON MAYO STAND)

     FORCEPS

Packing forceps, 05 Adson

     SCISSORS

fine, straight tenotomy, curved tenotomy, Iris

     NEEDLE HOLDERS

Webster needle holder, Crile-Wood needle holder

     RETRACTORS | SKIN HOOKS

Weitlannner sharp self retaining retractor

     KNIFE | BLADES

[2] 15 BP scalpel blades - HOLD

     OTHER

mosquito clamp for tongue traction suture

 

STERILE SUPPLIES

■[2]marking pens with ruler

■bacitracin ointment

■½" steri-strips for eyes

SPONGES

Raytec, 2" Kling for pharyngeal pack,

[3] 3" cotton tip applicators

NON-STERILE SUPPLIES

 

 

 

No

Type

SN

status

SUTURES

[ 2 ]

4-0 Chromic P3

1654

open

 

[ 2 ]

5-0 Chromic P-3

687

open

 

[ 2 ]

2-0 Silk SH

K833

open

 

 

 

 

 

 

 

DRAINS

none

DRESSINGS

bacitracin to lips

 

POSTOPERATIVE

cut tongue suture, remove pharyngeal pack

NOTES

 

 

COMMENTS

 

DATE MODIFIED

December 2008, Jan 2013