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Resumen El sentido del gusto tiene un papel importante porque ha permitido discriminar entre lo que puede ser alimento y lo que no, e incluso en lo que puede ser tóxico o peligroso al ingerirlo. La búsqueda de nuevos sabores está presente en toda la historia de la humanidad. Desde la antigüedad, las especias aportaron nuevas experiencias gustativas para hacer más palatables los alimentos o incluso para conservarlos durante más tiempo. La búsqueda de especias fue una motivación para realizar viajes que llevaron a descubrimiento de nuevas tierras y continentes. Más recientemente, la pandemia por un virus que altera los sentidos del olfato y del gusto, nos ha hecho recordar la importancia de estos sentidos. El sentido del gusto está determinado por unas pequeñas estructuras que se ubican en las papilas linguales. Hay cuatro tipos que definen cinco sabores y uno que aún está en duda. Las alteraciones de este sentido tienen varios posibles orígenes que se comentan en esta revisión.
Abstract Taste is relevant because it has allowed us to discriminate between what is food and what is not, and even what can be toxic or dangerous when ingested. The search for new flavors is present in history of mankind. Since ancient times, the spices provided new taste experiences to make meals more palatable or as a means of preserving food; the search for spices was a motivation to make voyages that led to the discovery of new lands and continents. More recently, a viral pandemic that damages the olfaction and taste senses made us to remember the relevance of the senses. Small structures, called taste buds, located in the papillae of the tongue are responsible of the sense of taste. There are four types of taste buds that identify five tastes and one whose existence has not yet been fully proven. Taste alterations have different etiologies which will be commented on this review.
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Resumen Introducción: La pigmentación de las papilas fungiformes linguales es una condición benigna y relativamente frecuente en pacientes con piel oscura. Suele aparecer en la segunda o tercera décadas de la vida y se han descrito casos de herencia autosómica dominante. El diagnóstico es clínico, pero la dermatoscopia es de gran ayuda: presenta un patrón clásico en pétalos de rosa. La patogénesis se desconoce y no hay tratamientos efectivos. Caso clínico: Reportamos el caso de una niña de 15 años con pigmentación de las papilas fungiformes y con patrón dermatoscópico compatible. Conclusiones: Conocer la existencia de esta afección y su característica dermatoscopia evita realizar pruebas invasivas adicionales, ya que se trata una variante de la normalidad.
Abstract Introduction: Pigmented fungiform papillae of the tongue is a benign condition frequent in dark skin patients. It usually appears in the second or third decade of life, and it has been reported as autosomal dominant inheritance pattern. The diagnosis is clinical, but dermoscopy could be helpful: a classical rose petal pattern is observed. The pathogenesis is unknown, and no treatments are effective. Case report: We report a case of a 15-year-old girl with a pigmented fungiform papillae and a compatible dermatoscopy pattern. Conclusions: Knowing the existence of this entity and its characteristic dermoscopy, avoids additional invasive medical test. We have to know this entity because it is a variant of normality.
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Objective:To evaluate the prognostic significance of inflammatory biomarkers,prognostic nutritional index and clinicopathological characteristics in tongue squamous cell carcinoma(TSCC)patients who underwent cervical dissection.Methods:The retrospective cohort study consisted of 297 patients undergoing tumor resection for TSCC between January 2017 and July 2018.The study population was divided into the training set and validation set by 7:3 randomly.The peripheral blood indices of interest were preoperative neutrophil-to-lymphocyte ratio(NLR),lymphocyte-to-monocyte ratio(LMR),platelet-to-lymphocyte ratio(PLR),systemic immune-inflammation index(SII),systemic inflammation score(SIS)and prognostic nutritional index(PNI).Kaplan-Meier survival analysis and multivariable Cox regression analysis were used to evaluate independent prognostic factors for overall survival(OS)and disease-specific survival(DSS).The nomogram's accuracy was internally validated using concordance index,receiver operating characteristic(ROC)curve,area under the curve(AUC),calibration plot and decision curve analysis.Results:According to the univariate Cox regression analysis,clinical TNM stage,clinical T category,clinical N category,differentiation grade,depth of invasion(DOI),tumor size and pre-treatment PNI were the prognostic factors of TSCC.Multivariate Cox regression analysis revealed that pre-treatment PNI,clinical N category,DOI and tumor size were independent prognostic factors for OS or DSS(P＜0.05).Positive neck nodal status(N≥1),PNI≤50.65 and DOI＞2.4 cm were associated with the poorer 5-year OS,while a positive neck nodal status(N≥1),PNI≤50.65 and tumor size＞3.4 cm were associated with poorer 5-year DSS.The concordance index of the nomograms based on independent prognostic factors was 0.708(95％CI,0.625-0.791)for OS and 0.717(95％CI,0.600-0.834)for DSS.The C-indexes for external validation of OS and DSS were 0.659(95％CI,0.550-0.767)and 0.780(95％CI,0.669-0.890),respectively.The 1-,3-and 5-year time-dependent ROC analyses(AUC=0.66,0.71 and 0.72,and AUC=0.68,0.77 and 0.79,respec-tively)of the nomogram for the OS and DSS pronounced robust discriminative ability of the model.The calibration curves showed good agreement between the predicted and actual observations of OS and DSS,while the decision curve confirmed its pronounced application value.Conclusion:Pre-treatment PNI,clinical N category,DOI and tumor size can potentially be used to predict OS and DSS of patients with TSCC.The prognostic nomogram based on these variables exhibited good accurary in predicting OS and DSS in patients with TSCC who underwent cervical dissection.They are effective tools for predicting sur-vival and helps to choose appropriate treatment strategies to improve the prognosis.
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Congenital tongue dysplasia is rare in clinical practice.This paper reports a case of congenital tongue dysplasia,and analyzes its possible mechanism in detail through literature review,so as to provide a basis for the prevention of this disease in the first trimester.Accord-ing to the current development conditions of the discipline,the author tries to put forward palliative care program suitable for this disease,es-pecially the serial treatment and psychological management of aglossia deformity,in order to improve the life quality of the children with this disease and provide a certain reference for clinical workers.
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Objective:To investigate the mechanism of interferon γ(IFN-γ)combined with ferroptosis inducer Erastin in the inhibi-tion of the growth of oral tongue squamous cell carcinoma(OTSCC).Methods:The expression of SLC7A11 in OTSCC was studied by bioinformatics analysis and immunohistochemical staining.SLC7A11 gene in OTSCC CAL-27 cells was knocked out by CRISPR-CAS9,and the survival rate of WT and SLC7A11 KO cells treated with Erastin was measured by MTT assay.Glutathione kit,lipid oxidation kit and flow cytometry were used to detect the changes of lipid peroxides in the cells treated with Erastin.After 24 h pretreatment with IFN-γ,MTT assay was used to detect the changes of cell sensitivity to Erastin,and the changes in lipid peroxides were detected by glu-tathione kits,lipid oxidation kits and flow cytometry.Results:Bioinformatics analysis and immunohistochemical staining showed that SLC7A11 was highly expressed in OTSCC.SLC7A11 KO CAL-27 cells were more sensitive to Erastin than WT cells.The GSH content of SLC7A11 KO cells was lower than that of WT cells,and the lipid peroxide content was higher than that of WT cells after treatment with Erastin.IFN-γ increased cell sensitivity to Erastin,decreased GSH content and increased lipid peroxides content in the cells.Conclusion:IFN-γ can reduce GSH and increase MDA and Lipid ROS levels by degrading SLC7A11,this increases the sensitivity of OTSCC to Erastin.
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Objective:To investigate the effects of gambogenic acid(GNA)on the proliferation and apoptosis of CAL27 cell xenograft tumor in nude mice.Methods:18 SPF nude mice were randomly divided into 3 groups(n=6).All nude mice were inoculated with CAL27 cells at logarithmic growth stage to establish subcutaneous transplanted tumor models.The mice in low and high dose GNA groups were treated with GNA of 8.0 mg/kg iv.and 16.0 mg/kg iv.every other day,respectively,and those in the control group was given the same amount of normal saline.The tumor growth curve was plotted during drug administration.2 weeks later,the nude mice were sacrificed,the tumor tissue was removed and the tumor inhibition rate was evaluated by the tumor size measurements.TUNEL as-say was used to detect the apoptosis of transplanted tumor cells in the groups.The expression levels of AKT,Bcl-2 and PI3K proteins in tumor tissue were detected by immunohistochemistry(IHC).The toxicity and side effects of GNA on normal tissues were detected by HE staining.Results:The transplanted tumors in low and high dose GNA groups grew slowly,and the tumor weight and volume were significantly lower than those in the control group(P＜0.05),the tumor inhibition ratio of low and high dose groups was 57.58％and 83.68％respectively.TUNEL results showed that the apoptosis index of GNA low and high dose groups was higher that of control group(P＜0.05).IHC results showed that the expression of AKT,Bcl-2 and PI3K in the tumor tissues of nude mice in low and high dose GNA groups was lower than that in the control group(P＜0.05).HE results showed that GNA had not effect on normal tissues and or-gans(P＜0.05);Conclusion:GNA may induce CAL27 cell apoptosis by regulating the expression of AKT,Bcl-2 and PI3K,and in-hibites the development of human tongue squamous cell carcinoma with little effect on normal tissues and organs.
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Objective:To investigate mevalonic acid(MEV)on reversing the antitumor effects of fluvastatin sodium(FS)on tongue squamous cell carcinoma(TSCC)cells.Methods:TSCC HSC-4 cells were treated with different concentrations of FS and MEV re-spectively or in combination.Cell counting kit-8,flow cytometry,wound healing,immunofluorescence and western blotting assays were conducted to examine cell proliferation,apoptosis and migration capacities,as well as the expression levels of Ras homolog family member A(RHOA),tissue factor(TF)and B-cell lymphoma-2-associated X(BAX)proteins,respectively.Results:FS inhibited HSC-4 cell proliferation and migration,decreased the expression of RHOA and TF,and increased BAX expression.MEV reversed the above antitumor effects of FS and promoted intracellular RHOA and TF expression.Conclusion:MEV reverses the antitumor effects of FS on HSC-4 cells in vitro.
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Objective:To observe the effect of Tongguan Liqiao(opening orifices)needling plus tongue pressure resistance feedback training in treating post-stroke deglutition disorders. Methods:A prospective randomized controlled trial was conducted.A total of 120 patients with post-stroke deglutition disorders were divided into a control group and an observation group using the random number table method,with 60 cases in each group.Both groups were treated with routine treatments.The control group was treated with additional tongue pressure resistance feedback training,and the observation group was treated with additional Tongguan Liqiao needling based on the same intervention in the control group.After 4 weeks of treatment,the clinical efficacy was evaluated,and the complications that occurred during treatment were summarized.The FUJISHIMA Ichiro food intake level scale(FILS)and the swallowing quality of life questionnaire(SWAL-QOL)were scored before treatment and after 4 weeks of treatment. Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).After 4 weeks of treatment,the FILS and SWAL-QOL scores in both groups were higher than those before treatment,and the scores in the observation group were higher than those in the control group(P<0.05).There was no statistical difference in the complication occurrence between the two groups(P>0.05). Conclusion:On the basis of routine treatments,Tongguan Liqiao needling plus tongue pressure resistance feedback training has a better effect in the treatment of post-stroke deglutition disorders.This method can effectively improve the swallowing function of patients,improve the quality of life,and is safe.
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Objective @#To investigate the correlation between tongue and pulse indicators and the outcome of live birth in patients undergoing frozen-thawed embryo transfer (FET), as well as the association between these indicators and patients’ endocrine parameters.@*Methods@#This study was conducted at Reproductive Medicine Center, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China, from March 8, 2021 to January 5, 2022. Patients undergoing FET were divided into live birth and non-live birth groups according to their live birth outcome. The differences between the endocrine parameters [basic follicle stimulating hormone (b FSH), basic luteinizing hormone (b LH), basic estradiol (b E2), basic progesterone (b P), basal endometrial thickness, follicle stimulating hormone (FSH) on endometrial transition day, luteinizing hormone (LH) on endometrial transition day, estradiol (E2) on endometrial transition day, progesterone (P) on endometrial transition day, and endometrial thickness on endometrial transition day] and the tongue and pulse indicators [tongue body (TB)-L, TB-a, TB-b, tongue coating (TC)-L, TC-a, TC-b, perAll, perPart, h1, h4, h5, t1, h1/t1, and h4/h1] of patients in the two groups were analyzed, with the correlation between these variables analyzed as well using Spearman’s correlation coefficient. Multivariate logistic regression was employed to identify the influential factors in the live birth prediction models across various datasets, including Model 1 consisting of endocrine indicators only, Model 2 solely consisting of tongue and pulse indicators, and Model 3 consisting of both tongue, pulse, and endocrine indicators, as well as to evaluate efficacy of the models derived from different datasets.@*Result@#This study included 78 patients in live birth group and 144 patients in non-live birth group. Compared with non-live birth group, live birth group exhibited higher levels of TB-L (P = 0.01) and TB-a (P = 0.04), while demonstrated lower levels of b FSH (P = 0.01), perAll (P = 0.04), and h4/h1 (P = 0.03). The Spearman’s correlation coefficient analysis revealed statistically significant correlation (P < 0.05) between TB-L, TB-b, TC-L, TC-b, perAll, perPart, h4, h5, t1, h1/t1 and b FSH, b LH, basal endometrial thickness, LH on endometrial transition day, E2 on endometrial transition day, P on endometrial transition day, and endometrial thickness on endometrial transition day in live birth group. The multivariate logistic regression analysis showed that the prediction Model 3 for live birth outcome [area under the curve (AUC): 0.917,95% confidence interval (CI): 0.863 − 0.971, P < 0.001] surpassed the Model 1 (AUC: 0.698,95% CI: 0.593 − 0.803, P = 0.001), or the Model 2 (AUC: 0.790, 95% CI: 0.699 − 0.880, P < 0.001). The regression equations for the live birth outcomes, integrating tongue and pulse indicators with endocrine parameters, included the following measures: FSH on endometrial transition day [odds ratio (OR): 0.523, P = 0.025], LH on endometrial transition day (OR: 1.277, P = 0.029), TB-L (OR: 2.401, P = 0.001), perPart (OR: 1.018, P = 0.013), h1(OR: 0.065, P = 0.021), t1 (OR: 4.354, P = 0.024), and h4/h1 (OR: 0.018, P = 0.016).@*Conclusion@#In infertility patients undergoing FET, there exists a correlation between tongue and pulse indicators and endocrine parameters. The corporation of tongue and pulse indicators significantly improved the predictive capability of the model for live birth outcomes. Specifically, tongue and pulse indicators such as TB-L, perPart, h1, t1, and h4/h1 exhibited a discernible correlation with the ultimate live birth outcomes.
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@#Image-based intelligent diagnosis represents a trending research direction in the field of tongue diagnosis in traditional Chinese medicine (TCM). In recent years, machine learning techniques, including convolutional neural networks (CNNs) and Transformers, have been widely used in the analysis of medical images, such as computed tomography (CT) and nuclear magnetic resonance imaging (MRI). These techniques have significantly enhanced the efficiency and accuracy of decision-making in TCM practices. Advanced artificial intelligence (AI) technologies have also provided new opportunities for the research and development of medical equipment and TCM tongue diagnosis, resulting in improved standardization and intelligence of the tongue diagnostic procedures. Although traditional image analysis methods could transform tongue images into scientific and analyzable data, recognizing and analyzing images that capture complicated tongue features such as tooth-marked tongue, tongue spots and prickles, fissured tongue, variations in coating thickness, tongue texture (curdy and greasy), and tongue presence (peeled coating) continues posing significant challenges in contemporary tongue diagnosis research. Therefore, the employment of machine learning techniques in the analysis of tongue shape and texture features as well as their applications in TCM diagnosis is the focus of this study. In the study, both traditional and deep learning image analysis techniques were summarized and analyzed to figure out their value in predicting disease risks by observing the tongue shapes and textures, aiming to open a new chapter for the development and application of AI in TCM tongue diagnosis research. In short, the combination of TCM tongue diagnosis and AI technologies, will not only enhance the scientific basis of tongue diagnosis but also improve its clinical applicability, thereby advancing the modernization of TCM diagnostic and therapeutic practices.
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ObjectiveTo investigate the objective characteristics of tongue manifestations in patients with coronary heart disease （CHD）. MethodsA total of 315 participants with CHD were recruited in the CHD group， and 211 healthy participants who underwent physical examination were recruited as the healthy control group. In addition， according to the common comorbidities （primary hypertension， carotid atherosclerosis， type 2 diabetes mellitus， fatty liver， hyperlipidaemia， heart failure， and cerebral infarction） in 315 participants with CHD， each comorbidity was classified into a group of comorbidities with that disease and a group of non-comorbidities. Tongue images were captured using a TFDA-1 tongue diagnostic instrument to characterise the tongue body （TB） and tongue coating （TC）， comparing the RGB， HIS， and Lab colour spaces in the chromaticity index （R， red； G， green； B， blue； H， hue； I， intensity； S， saturation； L， lightness； a， red-green axis； b， yellow-blue axis）， the tongue coating thickness index （per-All）， contrast （CON）， angular second moment （ASM）， entropy （ENT）， and mean （MEAN） in texture metrics. ResultsCompared with the healthy control group， the characteristic indexes of tongue body in CHD group showed lower TB-R， TB-G， TB-B， TB-I， TB-L and higher TB-H， TB-b； and the characteristic indexes of tongue coating in CHD group showed lower TC-R， TC-B and higher TC-CON， TC-MEAN， TC-H， TC-b （P＜0.05 or P＜0.01）. Compared with non-combined primary hypertension group， CHD combined primary hypertension group showed higher per-All， TB-G， TB-L， and lower TB-a， TC-a （P＜0.05）； compared with the non-combined carotid atherosclerosis group， CHD combined carotid atherosclerosis group showed higher TB-CON， TB-ENT， TB-MEAN， and lower TB-ASM （P＜0.05 or P＜0.01）； compared with the non-combined type 2 diabetes mellitus group， CHD combined type 2 diabetes mellitus group showed lower per-All and higher TB-H （P＜0.05 or P＜0.01）； compared with the non-combined fatty liver group， CHD combined fatty liver group showed higher TB-CON， TB-MEAN， TB-ENT， and lower TB-ASM and TC-S （P＜0.05 or P＜0.01）； compared with the non-combined hyperlipidaemia group， CHD combined hyperlipidaemia group showed lower TB-S and TB-a （P＜0.05）； compared with non-combined heart failure group， CHD combined heart failure group showed lower TB-R， TB-G， TB-I， TB-L， and higher TB-a （P＜0.05 or P＜0.01）； compared with non-combined cerebral infarction group， CHD combined cerebral infarction group showed higher TC-CON， TC-ENT， TC-MEAN， and lower TC-ASM （P＜0.05 or P＜0.01）. ConclusionCompared to healthy individuals， patients with CHD tend to have darker tongue colours and rougher TC textures. Compared with non-comorbidity participants， those with primary hypertension tended to be lighter tongue colour and thicker tongue coating， those with carotid atherosclerosis had paler tongue body， those with type 2 diabetes mellitus had thinner tongue coating， those with fatty liver disease had paler tongue body and whiter tongue colour， those with hyperlipidaemia and heart failure had paler tongue colour， and those with cerebral infarction had rougher tongue texture.
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@#Transoral robotic surgery (TORS) is a minimally invasive surgical technique that has recently gained popularity. This involves the use of a robotic system to access and operate on hard-to-reach areas of the body, such as the base of tongue and pharynx. General anesthesia is the technique of choice in TORS as this procedure poses unique challenges due to the patient's airway anatomy, the need for precise surgical movements, and the potential for postoperative complications. Awake fiberoptic intubation (AFOI) is the gold standard for an anticipated difficult airway. This case report describes the anesthetic management for a patient undergoing TORS for a tongue base mass.
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Anesthesiaالملخص
OBJECTIVE@#To investigate a new noninvasive diagnostic model for nonalcoholic fatty liver disease (NAFLD) based on features of tongue images.@*METHODS@#Healthy controls and volunteers confirmed to have NAFLD by liver ultrasound were recruited from China-Japan Friendship Hospital between September 2018 and May 2019, then the anthropometric indexes and sampled tongue images were measured. The tongue images were labeled by features, based on a brief protocol, without knowing any other clinical data, after a series of corrections and data cleaning. The algorithm was trained on images using labels and several anthropometric indexes for inputs, utilizing machine learning technology. Finally, a logistic regression algorithm and a decision tree model were constructed as 2 diagnostic models for NAFLD.@*RESULTS@#A total of 720 subjects were enrolled in this study, including 432 patients with NAFLD and 288 healthy volunteers. Of them, 482 were randomly allocated into the training set and 238 into the validation set. The diagnostic model based on logistic regression exhibited excellent performance: in validation set, it achieved an accuracy of 86.98%, sensitivity of 91.43%, and specificity of 80.61%; with an area under the curve (AUC) of 0.93 [95% confidence interval (CI) 0.68-0.98]. The decision tree model achieved an accuracy of 81.09%, sensitivity of 91.43%, and specificity of 66.33%; with an AUC of 0.89 (95% CI 0.66-0.92) in validation set.@*CONCLUSIONS@#The features of tongue images were associated with NAFLD. Both the 2 diagnostic models, which would be convenient, noninvasive, lightweight, rapid, and inexpensive technical references for early screening, can accurately distinguish NAFLD and are worth further study.
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Humans , Non-alcoholic Fatty Liver Disease/diagnostic imaging , Ultrasonography , Anthropometry , Algorithms , Chinaالملخص
Objective To explore specific magnetic resonance imaging(MRI)features of somatic symptoms in depression by comparing the differences of brain gray matter volume in depression patients with and without somatic symptoms using voxel-based morphometry(VBM).Methods A total of 52 depression patients were recruited and divided into somatic and no somatic symptoms group according to the patient health questionnaire-15 score(＞9 and≤9,respectively).Forty gender-age-matched healthy volunteers were recruited as the control group.All subjects underwent MRI scanning.Imaging data were analyzed to explore the differences in brain gray matter between groups using VBM.Results Compared with control group,gray matter volume increased in the right superior temporal gyrus,and decreased in the right inferior orbitofrontal gyrus,right inferior temporal gyrus,left inferior orbitofrontal gyrus,and left superior temporal gyrus for depressive patients with somatic symptoms(P＜0.001);gray matter volume increased in the right middle temporal gyrus,and decreased in the right superior temporal gyrus and right inferior temporal gyrus for depressive patients without somatic symptoms(P＜0.001).Only the volume in the right tongue and left cingulate gyrus increased in depressive patients with somatic symptoms compared with that in patients without somatic symptoms(P＜0.01).Conclusion VBM-MRI has demonstrated increased volume in the tongue and cingulate gyrus in the somatic symptoms of depression.
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Background: The tongue is susceptible to a multitude of conditions that can be of developmental, neoplastic, or inflammatory nature, whose occurrence varies globally by age, sex, and ethnicity. The objective of the present study was to determine the incidence of tongue lesions among cases managed in a tertiary hospital in Tanzania. Methods: This study analyzed histological results of patients with tongue lesions diagnosed between 2016 and 2021. Data on the age and sex of the patients and histological diagnosis were collected. Data analysis was done using Statistical Package for the Social Sciences version 27. Results: A total of 190 samples of tongue lesions were studied and 18 different histological diagnoses were observed. Generally, a majority (84.2%) of the biopsied tongue lesions were malignant. The most common (74.7%) lesions diagnosed were squamous cell carcinoma followed by hemangioma (5.3%). A significant association was noted between the nature of the lesions and the age group and sex of the patients. Conclusion: This analysis depicts that tongue lesions are frequently encountered in patients managed in tertiary health facilities in Tanzania. A majority of these lesions are malignant tumors. The sex and age of the patients are determining factors for the occurrence of tongue lesions
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Humans , Male , Female , Tongue , Health Facilitiesالملخص
Introdução: A laserterapia de alta potência tem estabelecido proporções satisfatórias na odontologia e se tornando a primeira opção de conduta cirúrgica para procedimentos, trazendo qualidade de vida aos pacientes e praticidade aos Cirurgiões. Objetivo: Relatar caso clínico de frenectomia lingual com uso do laser de diodo de alta potência ressaltando os benefícios da conduta. Relato de caso: Paciente sexo feminino, leucoderma, sem alterações sistêmicas, chega à Clínica Escola de Odontologia da Universidade Federal de Campina Grande, com queixa principal de alterações na sua fonologia. No exame intraoral observou-se dificuldade de movimentação lingual e em formato de coração devido a inserção fibrosa do freio, sendo observado a Anquiloglossia. Após explicações da alteração, do tratamento, e assinatura do Termo de Consentimento, foi iniciado a cirurgia: antissepsia, anestesia com vasoconstrictor, e em modo contínuo utilizou-se o laser de diodo de alta potência (TW Surgical- MMO®) configurado em 2W de potência, fibra 600µm, no comprimento de onda infravermelho, de modo que as fibras fossem separadas uniformemente e promovesse mobilidade imediata da língua, por fim realizou-se uma sutura em ponto simples com fio reabsorvível. Para o pós-operatório foi prescrito Dipirona em caso de dor, e estabelecido o acompanhamento. No retorno de 7 dias observou-se cicatrização normal e não ingestão do medicamento, em 30 dias foi visto a completa cicatrização e mobilidade sem desconforto, além de relato da paciente de melhoria na condição de relacionamentos sociais, autoestima e deglutição. Conclusão: O resultado apresentado neste artigo ratifica a benefício da escolha do laser em comparação ao convencional, demonstrando que não há sangramento no trans e pós cirúrgico, além de favorecer o processo de reparação tecidual, da redução do tempo cirúrgico, aumento do conforto, e diminuição de uso de medicamento, desta forma associando o laser cirúrgico a melhoria da qualidade de vida.
Introduction: High-power laser therapy has established satisfactory proportions in dentistry and has become the first choice for surgical procedures, bringing quality of life to patients and convenience to surgeons. Objective: To report a clinical case of lingual frenectomy using high-power diode laser, highlighting the benefits of this approach. Case report: A female patient, leucoderma, without systemic alterations, arrived at the Dental School Clinic of the Federal University of Campina Grande with the main complaint of alterations in her phonology. In the intraoral examination, difficulty in lingual movement and a heart-shaped tongue due to fibrous insertion of the frenum were observed, indicating Ankyloglossia. After explanations of the condition, treatment, and signing of the Informed Consent Form, the surgery was initiated: antisepsis, anesthesia with vasoconstrictor, and continuous mode using a high-power diode laser configured at 2W of power, 600µm fiber, at an infrared wavelength, with the aim of uniformly separating the fibers and promoting immediate tongue mobility. Finally, a simple suture was performed using absorbable thread. For the postoperative period, Dipyrone was prescribed for pain relief, and follow-up was established. At the 7-day follow-up, normal healing was observed, and the patient did not require the medication. At 30 days, complete healing and discomfort-free mobility were observed, along with the patient's testimony of improvement in social relationships, self-esteem, and swallowing. Conclusion: The results presented in this article confirm the benefits of choosing laser therapy over conventional methods, demonstrating the absence of bleeding during and after surgery, promoting tissue repair, reducing surgical time, increasing comfort, and decreasing the use of medication. Therefore, the use of surgical laser is associated with an improvement in quality of life.
Introducción: La terapia láser de alta potencia se ha establecido en proporciones satisfactorias en odontología y se ha convertido en la primera elección para procedimientos quirúrgicos, aportando calidad de vida a los pacientes y practicidad a los cirujanos. Objetivo: Relatar un caso clínico de frenectomía lingual con láser de diodo de alta potencia, destacando los beneficios de este procedimiento. Relato del caso: Paciente del sexo femenino, leucoderma, sin alteraciones sistémicas, llegó a la Clínica de la Facultad de Odontología de la Universidad Federal de Campina Grande con la queja principal de alteraciones en su fonología. El examen intraoral reveló dificultad en el movimiento lingual y lengua en forma de corazón debido a la inserción fibrosa del freno, observándose anquiloglosia. Tras explicar la alteración, el tratamiento y firmar el consentimiento, se inició la cirugía: antisepsia, anestesia con vasoconstrictor y uso continuado de un láser de diodo de alta potencia (TW Surgical- MMO®) configurado a 2W de potencia, fibra de 600µm, a longitud de onda infrarroja, para que las fibras se separaran uniformemente y favorecieran la movilidad inmediata de la lengua, y finalmente una sutura de punto único con hilo reabsorbible. En el postoperatorio, se prescribió dipirona en caso de dolor y se estableció un seguimiento. En el seguimiento a los 7 días, se observó una cicatrización normal y no se tomó medicación. A los 30 días, se observó una cicatrización completa y movilidad sin molestias, así como el informe del paciente de una mejora de las relaciones sociales, la autoestima y la deglución. Conclusión: Los resultados presentados en este artículo confirman el beneficio de la elección del láser frente a la cirugía convencional, demostrando que no hay sangrado durante ni después de la cirugía, además de favorecer el proceso de reparación tisular, reducir el tiempo quirúrgico, aumentar el confort y reducir el uso de medicación, asociando así el láser quirúrgico a una mejor calidad de vida.
الموضوعات
Female , Adult , Laser Therapy , Oral Frenectomy , Surgery, Oral , Dentists , Case Reports as Topic , Lingual Frenumالملخص
La hemorragia producida por lesión de la arteria lingual en la base de la lengua por cirugías o por tumores es infrecuente. La mayor frecuencia en la indicación de abordajes transorales para tratar diferentes patologías que afectan la orofaringe requiere que el equipo quirúrgico tenga experiencia en el manejo de esta complicación. La ligadura de la arteria lingual en el cuello es una técnica quirúrgica muy eficaz para solucionar la hemorragia, pero es importante conocer las posibles variantes anatómicas que puede tener la arteria en su trayecto cervical. Debido a su baja incidencia se propone como objetivo describir dos casos clínicos de pacientes que tuvieron hemorragias graves por lesión de la arteria lingual en la base de la lengua, producidas por daño quirúrgico y por erosión por tumor. [AU]
The bleeding caused by injury to the lingual artery at the base of the tongue due to surgery or tumors is infrequent. The increased frequency in the indication of transoral approaches to treat different pathologies affecting the oropharynx requires the surgical team to have experience in managing this complication. Ligation of the lingual artery in the neck is a very effective surgical technique to solve the bleeding; however, it is essential to be aware of the possible anatomical variants the artery may have in its cervical trajectory. Due to its low incidence, we propose to describe two clinical cases of patients who had severe bleeding due to a lesion of the lingual artery at the base of the tongue, produced by surgical damage and erosion due to a tumor. [AU]
الموضوعات
Humans , Male , Middle Aged , Aged , Tongue/surgery , Tongue/blood supply , Oral Hemorrhage/therapy , Tongue/anatomy & histology , Ligation/methodsالملخص
SUMMARY: The geese's tongue filiform papillae are particularly long, and exhibit the same morphology of a tooth, evoking the lingual teeth of several fishes. In adult animals, they contain numerous mechanical Herbst's corpuscles but no taste buds. In the embryo, they appear since stage 38 and acquire their definitive shape between stages 38 and 42. They express several proteins associated with mammalian tooth development (BMP4, β-catenin, SHH, PITX2, PAX9), also known to be linked to parrot's pseudoteeth and goose's denticulations development. Neurofilaments are early present in the papillae primordia, and appear particularly numerous in adult papillae. Our results suggest that these papillae constitute a mechanical organ with a « tooth shape » derived from ancestral odontodes, whose development is controlled by numerous genes involved in classical odontogenesis.
Las papilas filiformes de la lengua de los gansos son particularmente largas y exhiben la morfología de un diente, evocando los dientes linguales presentes en varios peces. En los animales adultos, contienen numerosos corpúsculos de Herbst mecánicos, aunque una ausencia de papilas gustativas. En el embrión, aparecen a partir del estadio 38 y adquieren su forma definitiva entre los estadios 38 y 42. Expresan varias proteínas asociadas al desarrollo dentario de los mamíferos (BMP4, β-catenina, SHH, PITX2, PAX9), también conocidas por estar asociadas al desarrollo de pseudodientes en el loro y denticulaciones en el ganso. Los neurofilamentos están presentes tempranamente en los primordios de las papilas y aparecen particularmente numerosos en las papilas adultas. Nuestros resultados sugieren que estas papilas constituyen un órgano mecánico con «forma de diente» derivado de odontoides ancestrales, cuyo desarrollo está controlado por numerosos genes implicados en la odontogénesis clásica.
الموضوعات
Animals , Tongue/anatomy & histology , Tongue/metabolism , Geese/anatomy & histology , Tongue/embryology , Immunohistochemistry , Homeodomain Proteins , PAX9 Transcription Factor , Hedgehog Proteins , Bone Morphogenetic Protein 4الملخص
Abstract New methods of early detection and risk assessment have been studied aiming to predict the prognosis of patients and directing a specialized treatment of the oral tongue squamous cell carcinoma (OTSCC). In this context, several molecular biomarkers have been investigated for this purpose, and, among them, the heat shock protein 27 (HSP27) can be named. The study aimed to analyze whether heat shock protein 27 (HSP27) exerts any influence on OTSCC, correlating its immunoexpression with clinicopathological parameters, and patient survival. The sample comprised 55 OTSCC cases and 20 normal oral mucosa specimens. The malignancy grading systems proposed by the WHO in 2005, Brandwein-Gensler et al., and Almangush et al. were applied in a histomorphological study. HSP27 expressions were evaluated through the Immunoreactivity Score System (IRS). Significant values were considered at p <0.05 for all statistical tests. Higher IRS results were observed for normal oral mucosa specimens when compared to OTSCC cases (p <0.001). No significant associations between HSP27 immunostaining, the analyzed clinicopathological parameters and patient survival were observed. The results of the present study indicate lower HSP27 expression in OTSCC cases compared to normal oral mucosa specimens. Thus, HSP27 expression does not seem to influence patient prognosis.
Resumo Novos métodos de detecção precoce e avaliação de risco estão sendo estudados com o intuito de predizer o prognóstico dos pacientes e direcionar um tratamento diferenciado. Neste contexto, vários biomarcadores moleculares têm sido investigados com esta finalidade, dentre eles a heat shock protein 27 (HSP27). Esta pesquisa objetivou analisar se a HSP27 exerce alguma influência nos carcinomas de células escamosas de língua oral (CCELO), correlacionando a sua imunoexpressão com parâmetros clinicopatológicos e com a sobrevida dos pacientes. A amostra foi constituída por 55 casos de CCELO e 20 espécimes de mucosa oral normal. Os sistemas de gradação de malignidade propostos pela OMS em 2005, Brandwein-Gensler et al. e Almangush et al. foram aplicados em um estudo histomorfológico. A expressão da HSP27 foi avaliada através do Sistema de Escore de Imunorreatividade (IRS). Para todos os testes estatísticos foram considerados valores significativos com p<0,05. Foi observado um maior IRS para a mucosa oral normal quando comparado aos casos de CCELO (p<0,001). Não foram encontradas associações significativas entre a imunomarcação da HSP27 com os parâmetros clinicopatológicos analisados e com a sobrevida dos pacientes. Os resultados do presente estudo indicam uma menor expressão da HSP27 nos casos de CCELO quando comparados aos espécimes de mucosa oral normal. Assim, a expressão da HSP27 parece não influenciar o prognóstico dos pacientes.
الملخص
Introduction: Melkersson-Rosenthal Syndrome (MRS) is a rare neuro-mucocutaneous condition. It mainly includes three triads as orofacial swelling, facial palsy and fissured tongue. All of the classical triad may not be seen at the same time, as symptoms may appear in different interval of time and has a recurrence. MRS is diagnosed based on oligosymptomatic when two or more clinical features are present or monosymptomatic cases when there evidence of a non-necrotising, granulomatous cheilitis in patients with isolated facial or lip edema can be noted in biopsy. Case Presentation: In this case report a 18 year old male patient all the three classic clinical characteristic features as granulomatous cheilitis, unilateral facial muscle palsy and a fissured tongue are seen. The clinical features of this rare condition along with treatment procedure are presented. Conclusion: Oral corticosteroids are the mainstay in the treatment of MRS. Intralesional triamcinolone acetonide used in oro-facial edema. In recurrent cases of MRS need second-line immunosuppressants like methotrexate and thalidomide. In refractory recurrent facial nerve palsies Surgical decompression of the facial nerve may be considered.