the tongue

4th stage

Surgery
Lec-4
Dr.Ahmed

3/4/2016

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

Treatment :

Stop irritation
Wash with antiseptic
Excisional biopsy
Diathermy coagulation

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

Tongue ulcer :

Traumatic e.g. denture
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.
Neoplastic :Scc (commonest),lymphoma.

The lip

Common lesions :
Herpis simplex infection :
- Fever
- Trauma
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.