A Congenital Tongue Mass.

A 13-month-old male presents with a firm left anterior tongue mass noted since birth that has increased proportionally with the child's growth. What is your diagnosis?

Surgical and Speech Therapy Evaluation of Lingual Frenulum.

Interdisciplinary evaluation is essential to diagnose and define clinical conduct for children and adults presenting with an altered lingual frenulum; however, there are few reports on the subject in the literature. In this context, the following study exemplifies a proposed protocol for the surgical and SLT treatment of a lingual frenulum based on a review of the literature and the experience of speech and language therapists and maxillofacial surgeons from hospitals in Santiago de Chile. After its application, a history of breastfeeding with difficulties and a maintained preference for soft foods was reported. Upon anatomic examination, the lingual apex was heart-shaped, and the lingual frenulum was fixed in the upper third of the ventral side of the tongue, with a pointed shape, submerged up to the apex, and of adequate thickness. Meanwhile, upon functional examination, the tongue was descended at rest, performed tongue protrusion with restrictions (raising and clicking), did not achieve attachment or vibration, and presented distortion of the sounds / r/ and /rr/. With this information, an altered lingual frenulum was diagnosed, with the indication for surgery and postoperative speech and language therapy. The constructed instrument allowed for the standardization of the evaluation in different teams but should be validated in future research.

A Young Man Presenting With Tongue Lesions.

A 19-year-old man presented with tongue pain of 3 months' duration and a raised tongue lesion with slightly hairy appearance. What is your diagnosis?

A Rare Case of Cleft Palate Associated With Tongue Hamartoma: A Case Report and Systematic Review.

INTRODUCTION: Palate development involves a genetic regulation through a complex molecular mechanism that may be disrupted by environmental factors, resulting in impaired fusion and cleft palate formation. An encounter with a case of cleft palate due to dorsal tongue hamartoma prompted us to perform this systematic review. OBJECTIVE: To review the clinical profile and management approach for a case with cleft palate and tongue hamartoma. DESIGN: A systematic literature search was conducted using keywords related to cleft palate and tongue hamartoma in PubMed, Scopus, MEDLINE, and Scielo databases through December 2021, with no time or language restrictions. PATIENTS, PARTICIPANTS: Studies reporting patients with cleft palate and tongue hamartoma were included. MAIN OUTCOME MEASURE(S): Information related to clinical profile, diagnostic tests, histopathology, management, and outcomes were extracted.Fourteen relevant publications were identified with 16 cases reported so far. Among them, thirteen patients were females (81.25%), and 3 were males (18.75%). The age of presentation varied from birth to 19 years. Oral-facial-digital syndrome (type II) was the most commonly associated syndrome.Congenital tongue hamartoma with cleft palate is a rare presentation, which can present as an isolated entity or part of a syndrome. Genetic evaluation is warranted, particularly for multiple hamartomatous lesions. The preferred treatment is immediate excision of hamartoma while following a standard timeline for palatoplasty.

Cartilaginous choristoma on the lateral surface of the tongue: a case report.

A cartilaginous choristoma is a nonneoplastic nodular growth of histologically normal cartilage in an abnormal site. This report describes a case of a cartilaginous choristoma on the lateral surface of the tongue in a 65-year-old woman. The entire lesion was excised, and histologic examination revealed mature cartilaginous tissue surrounded by dense connective tissue. Choristomas are rare findings in the oral cavity, easily confused with proliferative processes or soft tissue neoplasms. Nevertheless, choristomas may be part of the differential diagnosis for lesions similar to the one described in this case report.

Lingual Osteoma-A Case Report and Literature Review.

Osteomas are rare benign bony tumors located in the tongue area. In most cases, patients presenting with a lingual osteoma are asymptomatic but may complain of the sensation of having a foreign body. Fewer than 100 cases of lingual osteoma have been reported worldwide. Here, we present 2 cases of tongue base osteoma that were treated with excision under a laryngoscope.

Bifid Tongue, Congenital Tongue Tumor, and Wide Bilateral Complete Cleft Palate.

ABSTRACT: Congenital tumor of tongue is not rare, but associated with cleft palate and bifid tongue is unusual. The authors describe a case of 7-year-old patient having bifid tongue, congenital tongue tumor, and cleft palate. Clinical features, physical and pathological examinations, possible diagnosis, and surgical treatment have been elaborated in this case report.

Actinomycosis of the ventral tongue with successful laser ablation therapy: A case report.

BACKGROUND: We present a first case report of an Actinomycosis lesion of the ventral tongue. Actinomycosis of the tongue is an uncommon finding. CASE DESCRIPTION: The 64-year-old female patient presented with a leukoplakic ventral tongue lesion. The diagnosis Actinomycosis was confirmed by histopathologic evaluation. The lesion was successfully treated with antibiotics and laser ablation therapy. PRACTICAL IMPLICATIONS: Diagnostic and therapeutic concerns are discussed. Clinicians are alerted to considering Actinomycosis within the differential diagnosis of leukoplakic tongue lesions.

Short lingual frenum in infants, children and adolescents. Part 2: Lingual frenum release. Functional surgical approach.

AIM: The aim of this study was to review the craniofacial growth impairment and different malfunctions associated with short lingual frenum and to assess the validity of lingual frenum surgery based on minimally invasive laser release with a myofunctional approach. MATERIALS AND METHODS: Thirty patients, children and adolescents whose ages ranged from 8 years to 18 years, diagnosed with a short lingual frenum and concomitant orthodontic problems and/or presence of associated muscular or postural problems, were treated in this study. Pre-operative tongue assessment was performed following morphological and functional criteria, consisting of measurement of the free tongue, and of visual assessment of tongue protrusion out of the mouth and elevation to the incisive palatal papilla. Postural evaluation was assessed in frontal and lateral view. Laser surgery was completed with local anaesthesia, using Erbium YAG laser (2940 nm, LightWalker, AT-Fotona, Ljubljana, Slovenia) equipped with sapphire conical tip (600 micron), with energy ranging from 120 to 160 mJ, at 15 Hz frequency, and varying the adjustable pulse duration from 300 µs to 600 µs. RESULTS: Significant improvement was noted in 29 of 30 patients comparing preoperative scores to both three-week and two-month post-op scores. Postural improvement was found in 18 of 30 patients, indicating the multifactorial involvement of different causes for correct body posture. CONCLUSION: This study confirmed the validity of Erbium:YAG laser surgery as an effective technique in children and adolescents to release a short lingual frenum. The functional approach of the procedure performed with the Erbium:YAG laser, and the concomitant myofunctional therapy demonstrated to be simple and safe in children, and adolescents. Because of the multifactorial causes involved in correct body posture, an adequate osteopathic therapy is important to successfully complete the full body rehabilitation.

Congenital fibrous hamartoma of the tip of the tongue: A novel peculiar entity.

Congenital fibrous hamartoma of the tip of the tongue, a peculiar and novel entity, consists of one or two asymptomatic pearly or yellowish nodules, not exceeding 0.5 cm in maximum diameter, at the tip of the tongue, ventrally or dorsally. Unlike other localizations, congenital fibrous hamartoma of the tip of the tongue is not associated with cleft lip or palate, or with feeding problems. Surgical excision should be avoided, reserved only for dubious cases, since the lesions are benign and stable over time.

Vallecular cyst: a dangerous cause of failure to thrive in infants.

A 2-month-old full-term female infant with medical history of situs inversus totalis presented to the emergency department with congestion and abnormal breathing. She was discovered to have failure to thrive (FTT) and subsequently admitted. Investigations revealed a large vallecular mass at the base of her tongue which was noted to cause severe, intermittent airway obstruction. The mass underwent marsupialisation by otolaryngology (ENT) and pathology confirmed a diagnosis of vallecular cyst. The patient made a full recovery and is now growing and thriving. This case emphasises the need to consider anatomic airway abnormalities in the differential diagnosis of young infants with the constellation of respiratory symptoms and FTT. Such airway abnormalities can cause life-threatening airway obstruction if not discovered.

Treatment of tongue telangiectasia in a patient with hereditary haemorrhagic telangiectasia.

A 61-year-old Caucasian woman presented to an outpatient otolaryngology clinic with increased bleeding from a dorsal tongue telangiectasia for 3 weeks. Her history was significant for hereditary haemorrhagic telangiectasia (HHT), a rare condition that causes vascular dysplasia, and recent symptomatic anaemia requiring blood transfusions. After failing medical management with topical haemostatic agents, she was offered and underwent surgical intervention to remove the tongue telangiectasia with duel therapy potassium titanyl phosphate (KTP) laser coblation and bevacizumab injections. A team of otolaryngologists removed the lesion without complications, and the patient denied bleeding, had minimal pain, and endorsed increased quality of life postoperatively. Tongue telangiectasias can cause life-threatening bleeding in some patients with HHT, and no surgical management guidelines exist to treat them. This case demonstrates the efficacy of KTP laser followed by bevacizumab injections in treating tongue telangiectasias in a patient with HHT.

Combination Laser Treatment With Real-Time Ultrasound Navigation for Oral Venous Malformations.

Vascular lesions, including hemangiomas and vascular malformations, are common benign diseases. More than 50% originate from blood vessels or vascular structures and are locate in the head and neck region. This study aimed to evaluate the efficiency and safety of a combination of laser treatments for oral venous malformations using ultrasound navigation. This study reports 3 cases of massive vascular malformation in the oral cavity, which were treated by a combination of a multiple spotted transmucosal irradiation technique (the so-called leopard technique) for the superficial layer, and intralesional photocoagulation for the deep layer using a neodymium-doped yttrium aluminum garnet laser, under real-time ultrasound navigation. All cases presented with a venous malformation with multiple blue swellings on the dorsum of the tongue, which had a maximum dimension of over 30 mm. The percent reduction in the size of the lesions was determined by magnetic resonance imaging. All cases showed a decrease in lesion volume of over 80%, without extensive tissue necrosis, 6 to 12 months after the laser treatment. None of the patients experienced any complications, and all were satisfied with the treatment outcome after one irradiation session.The results of this study suggest that laser treatment using ultrasound navigation is a promising approach for the safe and minimally invasive resolution of oral vascular lesions without scarring and loss of normal tissue architecture, sensation, oral function.

Giant sublingual hamartoma with medial cleft tongue: a case report and literature review.

Hamartomas commonly occur in respiratory and digestive organs, such as the lungs, pancreas, and liver; they rarely occur in the oral cavity, especially in the sublingual region. This report describes a 5-month-old boy who presented with a giant sublingual hamartoma and medial cleft tongue. He underwent corrective operations at 5 months, 11 months, and 31 months of age. Histopathological analysis revealed features suggestive of hamartoma. There have been no signs of recurrence. The boy exhibited normal speech development at 3 years of age; all other oral functions were unaffected at that time. This report includes a review of relevant literature. The findings in this report and previous literature suggest that a multidisciplinary approach, carefully planned staged surgery, and rehabilitation are needed to achieve favorable outcomes in patients with hamartoma in the oral cavity.

A Case of Extranodal Rosai-Dorfman Disease Presenting as an Isolated Mass on the Base of the Tongue in a 57-Year-old Woman.

BACKGROUND Rosai-Dorfman disease (RDD), is a rare, benign, proliferative, histiocytic disorder characterized by persistent massive lymphadenopathy, which mimics malignant tumors. Diagnosis of extranodal RDD without lymphadenopathy is difficult due to its unusual clinical manifestation and lack of typical histopathologic features. Hence, it requires both a high degree of clinical suspicion and careful histopathologic examination. CASE REPORT A 57-year-old woman presented with an isolated mass on the base of the tongue (BOT) without lymphadenopathy. Laryngoscopic examination revealed a mass on the midline of the BOT. The patient underwent complete surgical excision via suspension laryngoscopy with a CO2 laser. Based on the histopathologic features, including numerous histiocytic infiltrations with emperipolesis and cytoplasmic expression of S100 and CD68 in histiocytes, the diagnosis was confirmed as extranodal RDD. No further treatment was required, and follow-up evaluation revealed no evidence of recurrence. CONCLUSIONS Because no ideal therapeutic approach is available for RDD, treatment should be tailored to the clinical manifestations. To prevent airway obstruction and recurrence, surgery is considered an appropriate option in cases of localized RDD arising on the upper respiratory tract. We report an extremely rare case of extranodal RDD without lymphadenopathy in the BOT, and provide a detailed discussion of its clinical and histopathologic features and treatment with a brief review of the relevant literature.

Ultrasound guided transcervical drainage of tongue base abscess.

IMPORTANCE: Infected vallecular cysts should first be treated conservatively and if airway is compromised surgical treatment is considered. OBJECTIVE: The aim of this study was to determine the feasibility and safety of transcervical aspiration of an infected vallecular cyst. DESIGN: A retrospective review of a novel technique that has been used for drainage of vallecular cyst abscesses for 5 years (2012 to 2017). SETTING: Galilee Medical Center affiliated to Azrieli Faculty of Medicine. PARTICIPANTS: Consecutive patients who underwent ultrasound guided percutaneous vallecular cyst drainage. MAIN OUTCOME & MEASURES: Medical records were reviewed to identify patient characteristics, symptoms, and outcomes. RESULTS: During 2012-2017, seven patients underwent transcutaneous ultrasound-guided drainage of a tongue-base abscess as an in-hospital office procedure. In all patients the technique described above was feasible. About a month after the procedure, patients underwent surgical marsupialization of the cyst under general anesthesia. CONCLUSIONS AND RELEVANCE: Ultrasound guided transcutaneous needle drainage of a base of tongue abscess is possible as it may achieve palliation and obtain material for culture. In this first-described series we show this technique's feasibility. Physicians should be familiar with this technique as it can easily be done under ultrasound guidance in the clinic using local anesthesia, and culture may be obtained, airway obstruction relieved, and recovery facilitated.