the tongue

Tongue

Anomalies of the tongue

Aglossia
Tongue tie.
Bifid
Lingual thyroid
Congenical fissured tongue
Geographic tongue
Macroglossia



























Congenital causes of macroglossia

Cavernous haemangioma

A-V fistulae
Lymphangioma
Neurofibromatosis

Aquired causes

- Muscular hypertrophy
- Amyloidosis
- Acromegaly
- Diffuse carcinoma ,sarcoma

TONGUE INJURIES

Mechanism of injury :
Tongue biting (epileptic fit )
Fracture jaw
C/F: bleeding ,if unconscious may be sever
Rx : arrest bleeding (pressure )
Suturing UGA
Haematoma may need tracheostomy

Inflammation of tongue

1- Acute :superficial (red, painful) or deep due to streptococcal infection or angioneurotic edema may need tracheostomy
2- Chronic :
Due to irritation by smoking, denture ,sharp tooth.(erythroplakia then leukoplakia)

Treatment

Stop irritation
Wash with antiseptic
Excisional biopsy
Diathermy coagulation

3. Tuberculer glossitis

4 . Syphilitic glossitis at any stage of the disease 1ry ,2ry and 3ry.
5. Candida glossitis (oral thrush)
6. Apthus ulcer

Tongue ulcer

1- Traumatic e.g. denture
2- Inflammatory :
Acute : apthus painful 2 weeks spontaneous healing,lichin planus ,herpetic.
Chronic : tubercular ulcer (undermined edge +submandibular L.N
Treatment: anti TB +antiseptic wash +anesthetic jelly.
Syphilitic ulcer.
Chronic superficial glossitis.
3- Neoplastic :Scc (commonest),lymphoma.

The lip

Common lesions
1- Herpis simplex infection :
- Fever
- Trauma
2- Malignant :carcinoma

Carcinoma of the lip

Commonly in the lower lip away from the contact with the upper lip.
Only 5%in the upper lip .


Spread
Laterally rather than deeply.
If uncontrolled it can spread to ant. Triangle of neck and invade the mandible.
L .n. metastasis late.

Treatment

Both surgery and radiotherapy are highly effective with cure rate 90%
Up to one third of the lip can be removed with primary suture
Larger tumor needs facial flap.