1
Forth stage
Surgery
Lec-2
د.احمد ابراهيم
3/4/2016
Tongue
Anomalies of the tongue :
1. Aglossia
2. Tongue tie.
3. Bifid
4. Lingual thyroid
5. Congenical fissured tongue
6. Geographic tongue
7. Macroglossia
2
Congenital causes of macroglossia :
1. Cavernous haemangioma
2. A-V fistulae
3. Lymphangioma
4. Neurofibromatosis
Aquired causes:
1.
Muscular hypertrophy
2. Amyloidosis
3. Acromegaly
4. Diffuse carcinoma ,sarcoma
TONGUE INJURIES :
Mechanism of injury :
Tongue biting (epileptic fit )
Fracture jaw
C/F: bleeding ,if unconscious may be sever
Rx : arrest bleeding (pressure )
Suturing UGA
Haematoma may need tracheostomy
3
Inflammation of tongue :
1. Acute : superficial (red, painful) or deep due to streptococcal infection or
angioneurotic edema may need tracheostomy
2. Chronic : Due to irritation by smoking, denture ,sharp tooth.(erythroplakia then
leukoplakia)
Treatment :
Stop irritation
Wash with antiseptic
Excisional biopsy
Diathermy coagulation
3. Tuberculer glossitis
4. Syphilitic glossitis at any stage of the disease 1ry ,2ry and 3ry.
5. Candida glossitis (oral thrush)
6. Apthus ulcer
Tongue ulcer :
1. Traumatic e.g. denture
2. Inflammatory :
Acute:apthus painful 2 weeks spontaneous healing,lichin planus ,herpetic.
Chronic : tubercular ulcer (undermined edge +submandibular L.N )
Treatment: anti TB +antiseptic wash +anesthetic jelly.
-Syphilitic ulcer.
-Chronic superficial glossitis.
3. Neoplastic :Scc (commonest),lymphoma.
4
The lip
Common lesions :
1. Herpis simplex infection :
- Fever
- Trauma
2. Malignant :carcinoma
Carcinoma of the lip :
Commonly in the lower lip away from the contact with the upper lip.
Only 5%in the upper lip .
Spread :
1. Laterally rather than deeply.
2. If uncontrolled it can spread to ant. Triangle of neck and invade the mandible.
3. L .n. metastasis late.
Treatment:
1. Both surgery and radiotherapy are highly effective with cure rate 90%
2. Up to one third of the lip can be removed with primary suture
3. Larger tumor needs facial flap.