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DEVELOPMENTAL DISTURBANCE OF
TONGUE
Elvis Chiramel D
Third year BDS
Anterior two-third: From two lingual
swellings and one tuberculum impar, which
arises from the first branchial arch. The
...
DEVELOPMENTAL DISTURBANCES OF
TONGUE
1. Microglossia
2. Macroglossia
3. Ankyloglossia
4. Cleft tongue
5. Fissured tongue
6...
MICROGLOSSIA
It is a rare congenital anomaly manifested by
the presence of Rudimentary or small tongue
The condition whe...
5
CLASSIFICATION
I. True microglossia
II. Relative microglossia
TREATMENT
I. Orthognathic correction
II. Speech & language...
microglossia
MACROGLOSSIA
It is a condition when patient have an
enlarged tongue
May be congenital or acquired
ETIOLOGY FOR CONGENITA...
CAUSES FOR ACQUIRED MACROGLOSSIA
1. tumors in tongue such as
lymphangioma,hemagioma and
neurofibroma
2. Acromegaly
3. Mxed...
macroglossia
CLINICAL FEATURES
Noisy breathing
Difficulty with chewing/ swallowing
Drooling
Slurred speech
Widened interdental spa...
11
TREATMENT
Surgical reduction or trimming may be
required when macroglossia disturbs the
oropharyngeal function
ANKYLOGLOSSIA
It can be defined as a developmental
condition characterized by fixation of tongue
to the floor of the mout...
Partial ankyloglossia occurs as a result of
shortlingual frenum or due to a frenum which
attaches too near to the tip of t...
14
CLINICAL FEATURES
 speech disorders
 deformities in dental occlusion
 Difficulties in swallowing
TREATMENT
 Partial...
Ankyloglossia
CLEFT TONGUE
A complete cleft tongue occurs due to lack of
merging of lateral lingual swellings of this
organ
partially ...
Cleft tongue
FISSURED TONGUE
Its a malformation manifested clinically by
numerous small grooves on dorsal surface
radiationg out from ...
19
Clinical Features
 Grooves / furrows – 2-6mm
 Asymptomatic / mild burning sensation rarely
 Melkerson Rosenthal synd...
The lesions are ususally asymptomatic
unless debris is entrapped within the fissure
and causes irritation
Fissured tongu...
Fissured tongue
MEDIAN RHOMBOID GLOSSITIS
Synonyms- central paillary atrophy of the
tongue / posterior lingual papillary atrophy
It is a...
ETIOLOGY
It has been described as a congenital
abnormality of tongue due to failure of
tuberculum impar to retract before...
CLINICAL FEATURES
Lesion appears Ovoid, diamond rhomboid
shaped reddish patch on dorsal surface of
tongue immediately ant...
Median rhomboid glossitis
TREATMENT
antifungal agents-amphotericin B or
nystatin
BENIGN MIGRATORY GLOSSITIS
Synonyms-georgaphic tongue,erythema
migrans and wandering rash of tongue
ETIOLOGY
The exact et...
CLINICAL FEATURES
 The lesion occurs in about 1 to 3 % of population
 Females are affected more frequently than males by...
Benign migratory glossitis
TREATMENT AND PROGNOSIS
there is no specific treatment for erythem
migrans
heavy doses of vitamins and and topical
stero...
HAIRY TONGUE
 SYNONYMS- BLACK HAIRY TONGUE, LINGUA
NIGRA, LINGUA VILLOSA
Hairy tongue is characterized by marked
accumil...
ETIOLOGY
Chronic smokers
It occurs due to microorganisms such as
candida albicans
Systemic disturbances like anemia,gas...
CLINICAL FEATURES
formation of a pigmented thick matted layer
on the tongue surface heavily coated with
bacteria and fung...
Hairy tongue
TREATMENT
Cleaning and scrapping of tongue
Reducing the adminstration of long term
antibiotics
LINGUAL VARICES
It is a dilated , tortous vein which is often subjected
to increased hydrostatic pressure but is poorly
s...
CLINICAL FEATURES
 Varices usually involves the lingual ranine viens
 the involved veins appears red of purple shotlike ...
LINGUAL VARICES
LINGUAL THYROID
NODULE
it is an anomalous condition in which
follicles of thyroid tissue are found in the
substance of th...
CLINICAL FEATURES
It appears as a nodular mass in or near the base
of tongue just posterior to foramen caecum
Deeply sit...
Sagittal reconstruction of CT scan of the neck,
showing the lingual thyroid at the base of the
tongue.
HISTOPATHOLOGY
Lingual thyroid nodule consist of normal
mature thyroid tissue
Occasionally thryodi nodules may exhibit
c...
DIFFERNTIAL DIAGNOSIS
Thyroglossal tract cyst
Neoplasms
TREATMENT
Surgical excision
Suppresive therapy iwht supplement...
REFERENCE
Oral pathology-Shafer’s
Oral and maxillofacial pathology-Neville
Human anatomy-Chaurasia’s
Developmental disorders of tongue   elvis chiramel david
Developmental disorders of tongue   elvis chiramel david
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Developmental disorders of tongue elvis chiramel david

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Developmental disorders of tongue

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Developmental disorders of tongue elvis chiramel david

  1. 1. DEVELOPMENTAL DISTURBANCE OF TONGUE Elvis Chiramel D Third year BDS
  2. 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. 3. DEVELOPMENTAL DISTURBANCES OF TONGUE 1. Microglossia 2. Macroglossia 3. Ankyloglossia 4. Cleft tongue 5. Fissured tongue 6. Median rhomboid glossitis 7. Benign migratory glossitis 8. Hairy tongue 9. Lingual varices 10. Lingual thyroid nodule
  4. 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. 5 CLASSIFICATION I. True microglossia II. Relative microglossia TREATMENT I. Orthognathic correction II. Speech & language development
  6. 6. microglossia
  7. 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. 8. CAUSES FOR ACQUIRED MACROGLOSSIA 1. tumors in tongue such as lymphangioma,hemagioma and neurofibroma 2. Acromegaly 3. Mxedema 4. Amyloidosis 5. Angioedema
  9. 9. macroglossia
  10. 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. 11 TREATMENT Surgical reduction or trimming may be required when macroglossia disturbs the oropharyngeal function
  12. 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. 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. 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. 15. Ankyloglossia
  16. 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. 17. Cleft tongue
  18. 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. 19 Clinical Features  Grooves / furrows – 2-6mm  Asymptomatic / mild burning sensation rarely  Melkerson Rosenthal syndrome Chelitis granulomatosa, facial paralysis, scrotal tongue
  20. 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. 21. Fissured tongue
  22. 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. 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. 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. 25. Median rhomboid glossitis
  26. 26. TREATMENT antifungal agents-amphotericin B or nystatin
  27. 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. 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. 29. Benign migratory glossitis
  30. 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. 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. 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. 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. 34. Hairy tongue
  35. 35. TREATMENT Cleaning and scrapping of tongue Reducing the adminstration of long term antibiotics
  36. 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. 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. 38. LINGUAL VARICES
  39. 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. 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. 41. Sagittal reconstruction of CT scan of the neck, showing the lingual thyroid at the base of the tongue.
  42. 42. HISTOPATHOLOGY Lingual thyroid nodule consist of normal mature thyroid tissue Occasionally thryodi nodules may exhibit colloid degeneration or goiter
  43. 43. DIFFERNTIAL DIAGNOSIS Thyroglossal tract cyst Neoplasms TREATMENT Surgical excision Suppresive therapy iwht supplemental thyroid hormone can reduce the size of the lesion
  44. 44. REFERENCE Oral pathology-Shafer’s Oral and maxillofacial pathology-Neville Human anatomy-Chaurasia’s

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