White plaque of the lateral tongue

A healthy 48-year old white woman presented with a chief complaint of an 'irritated' sensation involving her tongue. The problem seemed to be limited to her left lateral tongue and had been noticed for at least six months by the patient. She also indicated the condition varied in severity.     

Psoriasis of the dorsal surface of the tongue

Psoriasis is primarily an inherited inflammatory skin disease, it is characterized by erythemato-squamous lesions that usually involve elbows, knees and the scalp. Oral manifestations are rare in psoriasis, infact, oral psoriasis involves 2% of psoriatic patients and usually it is observed with the onset of cutaneous lesions and progresses with them. Differential diagnosis should be done for Reiter's syndrome, leukoplakia and geographic tongue. The authors describe a case of tongue psoriasis without cutaneous lesions.     

Resolution of candidal lesions of the dorsal rat tongue by ketoconazole

The purpose of this study was to determine whether the mucosal alterations of the dorsal rat tongue produced by Candida albicans infection were reversible upon treatment with the antifungal drug ketoconazole. Following experimentally-produced infection, 17 rats showed clinical evidence of persistent lesions over a period of 20 weeks. Eight of these animals were then treated with ketoconazole daily for 2 weeks (20 mg/kg/day). Appropriate non-infected controls and ketoconazole-only controls were also maintained. Five weeks after the ketoconazole treatment, all animals were killed and the dorsal tongues evaluated clinically and histologically. Control groups showed no abnormalities. Of the 8 animals in the treated-lesion group, all showed lesional resolution, while only 2 of the 9 animals in the untreated-lesion group showed resolution of their lesions (p=0.002). These findings indicate that the epithelial changes produced by this candidal isolate for this period of time are reversible.     

Resolution of candidal lesions of the dorsal rat tongue by ketoconazole

The purpose of this study was to determine whether the mucosal alterations of the dorsal rat tongue produced by Candida albicans infection were reversible upon treatment with the antifungal drug ketoconazole. Following experimentally-produced infection, 17 rats showed clinical evidence of persistent lesions over a period of 20 weeks. Eight of these animals were then treated with ketoconazole daily for 2 weeks (20 mg/kg/day). Appropriate non-infected controls and ketoconazole-only controls were also maintained. Five weeks after the ketoconazole treatment, all animals were killed and the dorsal tongues evaluated clinically and histologically. Control groups showed no abnormalities. Of the 8 animals in the treated-lesion group, all showed lesional resolution, while only 2 of the 9 animals in the untreated-lesion group showed resolution of their lesions (p = 0.002). These findings indicate that the epithelial changes produced by this candidal isolate for this period of time are reversible.     

Electrical response to acid across the dorsal epithelium of the frog tongue

Acid stimulation produced a change in trans-epithelial potential difference across isolated dorsal epithelium of frog tongue. The responses to acetic acid, tartaric acid and citric acid were significantly greater than those to hydrochloric acid and nitric acid at the same pH. Metabolic inhibitors had no effect on the response, but local anaesthetics reversibly depressed it. The induced response was associated with a decrease in tissue resistance. Positive polarization on the mucosa increased the response, which was decreased or reversed under negative polarization. These responses may be caused by diffusion of H-ions through the tissue, and may influence sour reception in the frog.     

Subgemmal neurogenous plaque of the tongue: a report of three cases

Subgemmal neurogenous plaque (SNP) is a biphasic neural structure associated with the taste buds. Clinically, SNP usually presents as an asymptomatic, normally colored, papule located in the posterior lateral border of the tongue. Accurate diagnosis is based only on histopathological examination, which shows a superficial neurofibroma-like pattern and a neuroma-like in the deep zone. Appropriate recognition of clinical and morphological aspects of SNPs can avoid their misdiagnosis as neural neoplasms. We report three cases of SNP with detailed clinical, histopathological, and immunohistochemical features.     

White, exophytic lesion of the left lateral surface of the tongue

Verrucous carcinoma is an unusual variant of squamous cell carcinoma; it comprises approximately 5% of all oral malignancies. The buccal mucosa, gingiva, and tongue are the most commonly involved areas within the oral cavity. Histologically, verrucous carcinoma can present a diagnostic dilemma. The basement membrane is often intact, which may cause the pathologist to misinterpret these carcinomas as hyperkeratosis and severe dysplasia. The preferred treatment for this lesion is wide local excision. Regional lymph node dissection is usually not necessary and radiation therapy appears to be contraindicated. Close follow-up is recommended.     

Experience with dorsal tongue flaps for closure of defects of the hard palate

The use of dorsal tengue flaps for covering large defects of the palate is described. This technique is considered advantageous, compared with the pedicle tubular flaps previously used, because of the reduced number of surgical procedures required, the shortened treatment time involved, the relative lack of complications, and the consistently good results that are achieved.     

Surgical closure of end-stage palatal fistulas using anteriorly-based dorsal tongue flaps

Effective closure of the recurrent palatal fistula demands proper diagnosis and anatomically-based classification, combined with an appreciation of surgical options. The anteriorly-based dorsal tongue flap is recommended to close large and/or compromised end-stage residual palatal fistula, provided that patient selection and surgical technique are meticulous. It has proved to be a safe and effective method of solving a difficult problem.     

Rapair of a palatal defect using a dorsal pedicle tongue flap

Closure of a large oronasal defect using a tongue pedicle flap is reported. This technique is indicated in instances where palatal or buccal mucosal grafts cannot be reasonably expected to succeed because of the size and/or position of the defect.     

Microbiota of the dorsum of the tongue after plaque accumulation: an experimental study in humans

BACKGROUND: The purpose of the present investigation was to determine the effect of the absence of tongue hygiene on the microbiota of the dorsum of the tongue. METHODS: Ten volunteers (aged 19 to 22 years) entered the study at baseline and were instructed to abstain from tongue cleaning for 7 days, followed by a period of 3 days without any kind of oral hygiene. Subsequently, a period of 21 days of washout was employed, and this protocol was repeated three times. Microbiological samples were obtained from the dorsum of the tongue at baseline and at the end of the period of coating accumulation and analyzed using the checkerboard DNA-DNA hybridization technique. RESULTS: The species found in highest mean counts at baseline and day 10 were Prevotella melaninogenica and Veillonella parvula. The mean bacterial total counts enhanced significantly during the study (from 17.1x10(6) to 33.7x10(6)). Proportions of red and blue complexes and levels of 18 species also increased after the period of coating accumulation, including several periodontal pathogens, such as Prevotella intermedia, Prevotella nigrescens, Streptococcus constellatus, Tannerella forsythensis, Porphyromonas gingivalis, Treponema denticola, and P. melaninogenica. CONCLUSION: The tongue surface could be an important reservoir for periodontal pathogens and may play a role in the recolonization of tooth surfaces and in the etiology of oral halitosis.     

Single layer closure of palatal fistula using anteriorly based dorsal tongue flap

Palatal fistulas are the common complications seen after cleft palate repair. Small fistula may be asymptomatic, the large ones produce various symptoms including regurgitation of fluids into nasal cavity and interference with normal speech. Although small fistulas can be successfully treated with local flaps such as palatal or buccal mucosal flaps, large fistulas pose difficulty. Because of rich blood supply, tongue is a suitable and convenient source of large flap. The anterior based dorsal tongue flap is a safe and effective method for closure of relatively large recurrent palatal fistula with out any functional impairment of donor site. This article describes one such case treated by single layer closure using anteriorly based tongue flap with excellent outcome.