Developmental disorders of tongue elvis chiramel david

Developmental disorders of tongue

1. Developmental disturbance of tongue Elvis Chiramel David Third year BDS

2. Anterior two-third: From two lingual swellings and one tuberculum impar , which arises from the first branchial arch. The tuberculum impar soon disappears. Posterior one-third: From cranial large part of the hypobranchial eminence, ie . from the third arch Posteriormost part from the fourth arch Development of tongue

3. Developmental disturbances of tongue Microglossia Macroglossia Ankyloglossia Cleft tongue Fissured tongue Median rhomboid glossitis Benign migratory glossitis Hairy tongue Lingual varices Lingual thyroid nodule

4. Microglossia It is a rare congenital anomaly manifested by the presence of Rudimentary or small tongue The condition when tongue being completely absent is known as aglossia Patient finds difficulties in eating and swallowing

5. 5 CLASSIFICATION True microglossia Relative microglossia TREATMENT Orthognathic correction Speech & language development

6. microglossia

7. Macroglossia It is a condition when patient have an enlarged tongue May be congenital or acquired Etiology for congenital macroglossia Congenital macroglossia is due to an over development of the musculature Down syndrome Beckwith- Wiedemann syndrome

8. Causes for ACQUIRED macroglossia tumors in tongue such as lymphangioma,hemagioma and neurofibroma Acromegaly Mxedema Amyloidosis Angioedema

9. macroglossia

10. Clinical features Noisy breathing Difficulty with chewing/ swallowing Drooling Slurred speech Widened interdental space Scalloping/ crenations Open bite/ mandibular prognathism Dry/ cracked tongue Ulceration/ secondary infection/ hemorrhage

11. 11 Treatment Surgical reduction or trimming may be required when macroglossia disturbs the oropharyngeal function

12. ankyloglossia It can be defined as a developmental condition characterized by fixation of tongue to the floor of the mouth,causing restricted movement It can be either complete ankylogssia or partial ankyloglossia (tongue tie )

13. Partial ankyloglossia occurs as a result of shortlingual frenum or due to a frenum which attaches too near to the tip of the tongue Complete ankyloglossia occurs as a result of fusion between the tongue and the floor of the mouth

14. 14 Clinical features speech disorders deformities in dental occlusion Difficulties in swallowing Treatment Partial ankyloglossia are self corrective Complete ankyloglossia can be surgically treated by frenulectomy

15. Ankyloglossia

16. cleft tongue A complete cleft tongue occurs due to lack of merging of lateral lingual swellings of this organ partially cleft tongue occurs more common and is manifested as deep groove in the midline of dorsal surface Partial cleft tongue occurs due to incomplete merging and failure of groove obliteration by underlying mesenchymal prolifetation food debris and microorganisms collect in base of cleft and cause irritation

17. Cleft tongue

18. FISSURED TONGUE Its a malformation manifested clinically by numerous small grooves on dorsal surface radiationg out from central groove along the midline of tongue ETIOLOGY It also occurs as a sequel to geographic tongue Hereditary factors

19. 19 Clinical Features Grooves / furrows – 2-6mm Asymptomatic / mild burning sensation rarely Melkerson Rosenthal syndrome Chelitis granulomatosa , facial paralysis, scrotal tongue

20. The lesions are ususally asymptomatic unless debris is entrapped within the fissure and causes irritation Fissured tongue affects the dorsum surface and often extends to the lateral bordres of the tongue and form lobules

21. Fissured tongue

22. median rhomboid glossitis Synonyms- central paillary atrophy of the tongue / posterior lingual papillary atrophy It is an asymptomatic elongated erythematous patch of artophic mucosa on the middorsal surface of the tongue

23. Etiology It has been described as a congenital abnormality of tongue due to failure of tuberculum impar to retract before fusion of lateral halves of tongue so that structure devoid of papillae is interpose between them It is a focal area of susceptibility to chronic infections by candida albicans 23

24. clinical features Lesion appears Ovoid, diamond rhomboid shaped reddish patch on dorsal surface of tongue immediately anterior to circumvallate papillae. it appears as a flat or slightyly elevated area and stands out distinctly from rest of tongue because it has no filliform papillae Seen mostly in females in a ratio 3:1 when compared with males Kissing lesions are seen.

25. Median rhomboid glossitis

26. treatment antifungal agents- amphotericin B or nystatin

27. benign migratory glossitis Synonyms -georgaphic tongue,erythema migrans and wandering rash of tongue ETIOLOGY The exact etiology remains unknown. It may be genetic. However many investigators believe that emotional stress may precipitate this condition

28. CLINICAL FEATURES The lesion occurs in about 1 to 3 % of population Females are affected more frequently than males by a 2:1 ratio Geographic tongue is usually seen on the anterior two third of the dorsal tongue mucosa the condition is characterized by multiple, well-demarcated, erythematous, depapillated patches, typically surrounded by a slightly elevated yellow white scalloped border, and usually restricted to the dorsumof the tongue  

29. Benign migratory glossitis

30. TREATMENT AND PROGNOSIS there is no specific treatment for erythem migrans heavy doses of vitamins and and topical steroids may produce someresutls in few cases

31. HAIRY TONGUE Synonyms- black hairy tongue, lingua nigra , lingua villosa Hairy tongue is characterized by marked accumilation of keratin on filliform papillae of the dorsal surface resulting in a hair like appearence

32. Etiology Chronic smokers It occurs due to microorganisms such as candida albicans Systemic disturbances like anemia,gastric upset Oral use of certain drugs like sodium perborate sodium peroxide and antibiotics such as penicillin Extensive x-ray radiation

33. Clinical features formation of a pigmented thick matted layer on the tongue surface heavily coated with bacteria and fungi Hair like appearence Halitosis Irritation of tongue due to accumulation of food debris Candidal over growth may cause glossopyrosis ( burning tongue)

34. Hairy tongue

35. Treatment Cleaning and scrapping of tongue Reducing the adminstration of long term antibiotics

36. LINGUAL VARICES It is a dilated , tortous vein which is often subjected to increased hydrostatic pressure but is poorly supported by surrouonding tissue

37. Clinical features Varices usually involves the lingual ranine viens the involved veins appears red of purple shotlike clusters of vessels on the ventral surface and lateral borders of tongue as well as in the floor of the mouth Presence of lingual varices before the ages of 50 indicates premature ageing Treatment There is no specific treatment for lingual varices

38. LINGUAL VARICES

39. Lingual thyroid nodule it is an anomalous condition in which follicles of thyroid tissue are found in the substance of the tongue ETIOLOGY It occurs when thyroid anlage that failed to migrate to its predestined position or from anlage remnants that became detached and were left behind

40. CLINICAL FEATURES It appears as a nodular mass in or near the base of tongue just posterior to foramen caecum Deeply situated and have a smooth surface The size varies from 2 – 3 cm Chief symptoms are dysphagia , dyspnea , dysphonia or fullnes of throat

41. Sagittal reconstruction of CT scan of the neck, showing the lingual thyroid at the base of the tongue.

42. HISTOPATHOLOGY Lingual thyroid nodule consist of normal mature thyroid tissue Occasionally thryodi nodules may exhibit colloid degeneration or goiter

43. Differntial diagnosis Thyroglossal tract cyst Neoplasms Treatment Surgical excision Suppresive therapy iwht supplemental thyroid hormone can reduce the size of the lesion

44. reference Oral pathology-Shafer’s Oral and maxillofacial pathology-Neville Human anatomy- Chaurasia’s

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