Look at an anatomy text to see the location of the lingual arteries. They are paired and run lateral to the genioglossus muscle in the blade of the tongue. The grooved director was actually invented by Dr. Petit over 400 years ago to avoid accidentally snipping the lingual veins which are superficial to the arteries! It forms a shield over the area of vasculature. Anyway, the frenotomy is performed in midline, and the vasculature is lateral to the frenotomy site. Many docs make a small snip and use blunt dissection (enlarging the opening in the mucous membrane with their finger over a sterile gauze pad) to further avoid the risk of excessive bleeding. So, while there can always be an anatomical variant and more bleeding than is expected, the risk of excessive bleeding from a properly performed frenotomy is very very small. Catherine Watson Genna BS, IBCLC NYC cwgenna.com On 7/20/2011 10:23 AM, Katherine Lilleskov wrote: > Just had a discussion with a pediatrician I respect who feels that it is dangerous to perform frenotomies on posterior tongue ties in the office due to the risk of severing the lingual artery and the possibility of hemmorhaging. She says that they should be done in the OR under general anesthesia so that if there was a complication it could be dealt with, since the bleeding could be fatal in an outpatient setting. Wanted to throw this out there for discussion. I have been sending many moms in to have the procedure done by a very competant local ENT in her office and feel a little shaken up by this conversation. > Kathy Lilleskov RN IBCLC > > *********************************************** > > Archives: http://community.lsoft.com/archives/LACTNET.html > To reach list owners: [log in to unmask] > Mail all list management commands to: [log in to unmask] > COMMANDS: > 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail > 2. To start it again: set lactnet mail > 3. To unsubscribe: unsubscribe lactnet > 4. To get a comprehensive list of rules and directions: get lactnet welcome *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome