Dr. Saleem Shaikh
Aglossia
 Macroglossia
 Hairy tongue
 Ankyloglossia
 Fissured tongue
 Cleft tongue
 Lingual thyroid
 Geographic tongue
 Median rhomboid glossitis
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Glossia - tongue
Small or absent tongue
This malformation is very rare, and may lead to
underdevelopment of the mandible.
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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.
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Congenital –
 Down syndrome
 Beckwith-Wiedemann syndrome
 Lingual thyroid
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Acquired –
 Candidiasis
 Scurvy
 Pellagra
 Acromegaly
 Neurofibromatosis
 Amyloidosis
 Carcinoma
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Patient complains of
difficulty in eating,
speaking.
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Airways may also be
compromised causing
difficulty in breathing.
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Tongue usually shows
crenated borders.
(scalloped lateral borders)
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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
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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
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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.
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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
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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
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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.
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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.
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presents in the posterior midline of the dorsum of the
tongue, just anterior to the V-shaped grouping of the
circumvalate papillae
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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.