Dr. Saleem Shaikh Aglossia Macroglossia Hairy tongue Ankyloglossia Fissured tongue Cleft tongue Lingual thyroid Geographic tongue Median rhomboid glossitis Glossia - tongue Small or absent tongue This malformation is very rare, and may lead to underdevelopment of the mandible. Enlarged tongue Types - True macroglossia and pseudo macroglossia. Pseudo macroglossia could be due to abnormal positioning of the tongue, eg - Habitual posturing of the tongue, Enlarged tonsils and/or adenoids displacing tongue, mandibular deficiency True is further divided into congenital causes acquired causes. Congenital – Down syndrome Beckwith-Wiedemann syndrome Lingual thyroid Acquired – Candidiasis Scurvy Pellagra Acromegaly Neurofibromatosis Amyloidosis Carcinoma Patient complains of difficulty in eating, speaking. Airways may also be compromised causing difficulty in breathing. Tongue usually shows crenated borders. (scalloped lateral borders) The basic defect in hairy tongue is a hypertrophy of filiform papillae on the dorsal surface of the tongue, usually due to a lack of mechanical stimulation and debridement. Seen in people with poor oral hygiene, eating a soft diet Patients frequently complain of a tickling sensation in the soft palate and the oral pharynx during swallowing Retention of food debris may cause halitosis May get pigmented usually known as black hairy tongue Treatment - simply brushing the tongue with a toothbrush or using a commercially available tongue scraper is sufficient TONGUE-TIE – the inferior frenulum attaches to the bottom of the tongue and subsequently restricts free movement of the tongue. Varies from mild to severe cause feeding problems in infants may also cause speech defects, Tongue tie may contribute to dental problems as well, causing a persistent gap between the lower central incisors. Frenectomy is recommended This is characterized by grooves that vary in depth and are noted along the dorsal and lateral aspects of the tongue. definitive etiology is unknown is also seen in Melkersson-Rosenthal syndrome and Down syndrome lesions are usually asymptomatic unless debris is entrapped within the fissure, this may cause burning sensation and lead to halitosis. The depth of the fissures varies but has been noted to be up to 6 mm in diameter. A cleft or bifid tongue is a rare condition that is apparently due to lack of merging (fusion) of the lateral lingual swellings. No clinical significance The lingual thyroid is an anomalous condition in which follicles of thyroid tissue are found in the substance of the tongue During development the thyroid gland develops in the floor of the pharynx, which remains as foramen caecum in the tongue Usually remnants of thyroid tissue in the tongue are asymptomatic but may enlarge in case of thyroid insufficiency. Treatment – excision only after proper evaluation BENIGN MIGRATORY GLOSSITIS It is seen as a pattern of wavy white lines surrounding areas of smooth, depapillated mucosa. The location and shape of the lesion is constantly changing The wavy lines on the tongue resemble outline of countries on a map Histologic features show presence of micro abcesses known as Munro’s abcess. It is now thought to be the oral manifestation of psoriasis but not yet proven beyond doubt. This was initially thought to be due to persistance of tuberculum impar during development of tongue, but recent evidence suggests that this could be due to chronic candidal infection. presents in the posterior midline of the dorsum of the tongue, just anterior to the V-shaped grouping of the circumvalate papillae Some cases may also demonstrate a midline soft palate erythema in the area of routine contact with the underlying tongue involvement; this is commonly referred to as a kissing lesion.