Black hairy tongue syndrome Gurvits, Grigoriy E; Tan, Amy
World journal of gastroenterology : WJG,
08/2014, Letnik:
20, Številka:
31
Journal Article
Odprti dostop
Black hairy tongue(BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies ...geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. Clinical presentation varies but is typically asymptomatic, although aesthetic concerns are common. Differential diagnosis includes pseudo-BHT, acanthosis nigricans, oral hairy leukoplakia, pigmented fungiform papillae of the tongue, and congenital melanocytic/melanotic nevi/macules. Clinical diagnosis relies on visual observation, detailed history taking, and occasionally microscopic evaluation. Treatment involves identification and discontinuation of the offending agent, modifications of chronic predisposing factors, patient’s re-assurance to the benign nature of the condition, and maintenance of adequate oral hygiene with gentle debridement to promote desquamation. Complications of BHT(burning mouth syndrome, halitosis, nausea, gagging, dysgeusia) typically respond to therapy. Prognosis is excellent with treatment of underlying medical conditions. BHT remains an important medical condition which may result in additional burden on the patient and health care system and requires appropriate prevention, recognition and treatment.
Background
We investigated the role of the soft tissue tract between the primary tumor and the neck lymph nodes, the “T‐N tract,” in patients with tongue squamous cell carcinoma at an advanced stage.
...Methods
We performed a compartmental tongue surgery in 233 patients. Cumulative incidence of relapses and overall survival curves were compared by T‐N tract involvement. Multivariate Cox proportional hazards models were used to assess the independent role of T‐N tract.
Results
At 4 years of follow‐up, patients with disease in the T‐N tract experienced a significantly more distant recurrence (40%) than did patients without T‐N tract involvement (22%; P = .02). Multivariate Cox models indicate a significant almost triple risk of distant metastases (hazard ratio HR, 2.70; 95% CI, 1.01‐7.19; P = .05) and double risk of death (HR, 2.09; 95%CI, 1.13‐3.85; P = .02) in patients with “T‐N tract involvement.”
Conclusions
Our data show that the T‐N tract plays an important role in prognosis and survival in patients with tongue cancer.
Diseases of the Tongue Mangold, Aaron R., M.D; Torgerson, Rochelle R., M.D., Ph.D; Rogers, Roy S., M.D
Clinics in dermatology,
07/2016, Letnik:
34, Številka:
4
Journal Article
Recenzirano
Abstract The tongue is a complex organ involved in speech and expression as well as in gustation, mastication, and deglutition. The oral cavity, along with the tongue, are sites of neoplasms, ...reactive processes, and infections, and may be a harbinger of systemic diseases. This review inludes both common and rare diseases that occur on the tongue including: vascular and lymphatic lesions (infantile hemangiomas and oral varices), reactive and inflammatory processes (hairy tongue, pigmented fungiform papillae of the tongue, benign migratory glossitis, and fissured tongue), infections (oral hairy leukoplakia, herpes simplex and varicella zoster virus infections, human papilloma virus, and candidiasis), premalignant lesions (leukoplakia and erythroplakia), malignant lesions (squamous cell carcinoma, Kaposi sarcoma, and lymphoproliferative diseases), and signs of systemic disease (nutritional deficiency and systemic amyloidosis).
Objectives/Hypothesis
Our primary objective was to evaluate the feasibility, morbidity, and efficacy of transoral robotic surgery (TORS) tongue‐base resection (TBR) combined with tongue‐base ...suspension (TBS) for obstructive sleep apnea (OSA) with tongue‐base collapse. Our secondary objective included evaluation of factors influencing treatment success.
Study Design
Single‐arm, prospective, observational cohort study.
Methods
Patients were eligible if they had moderate‐to‐severe OSA (apnea hypopnea index AHI > 15) or positional OSA, had a tongue‐base collapse and glossoptosis identified by drug‐induced sleep endoscopy (DISE), and failed continuous positive airway pressure. All patients underwent TORS‐TBR combined with TBS. Additionally, concomitant epiglottoplasty, uvulopalatopharyngoplasty, or expansion pharyngoplasty were performed based on DISE findings.
Results
In total, 64 patients were enrolled in the trial. The mean age was 45.9 years, mean body mass index was 30.5 kg/m2, and mean AHI was 41.7 events/hour. The mean robotic surgical time, total volume of tongue‐base tissue removed, and the length of hospital stay were 21.4 minutes, 15.16 mL, and 6.5 days, respectively. Postoperatively, almost all polysomnographic metrics improved significantly (AHI = 41.72 vs. 18.82 events/hour, lowest oxygen saturation = 80.43% vs. 85.14%, Epworth Sleepiness Scale = 10.49 vs. 4.09). The procedure provided an overall success rate of 75%, with minor morbidity. All patients experienced varying degrees of temporary lingual edema postoperatively. Tracheotomy was not required for any patient. Although no independent predictor of treatment success was determined, patients with more severe disease tend to exhibit lower response to the treatment.
Conclusions
TORS‐TBR combined with TBS is a feasible, safe, and efficient procedure for OSA with tongue‐base collapse.
Level of Evidence
4 Laryngoscope, 130:2285–2291, 2020
Oral squamous cell carcinoma (OSCC) is one of the most common types of the head and neck cancer. Chemo resistance of OSCC has been identified as a substantial therapeutic hurdle. In this study, we ...analyzed the role of miR-203 in the OSCC and its effects on cisplatin-induced cell death in an OSCC cell line, Tca8113. There was a significant decrease of miR-203 expression in OSCC samples, compared with the adjacent normal, non-cancerous tissue. After 3 days cisplatin treatment, the survived Tca8113 cells had a lower expression of miR-203 than that in the untreated control group. In contrast, PIK3CA showed an inverse expression in cancer and cisplatin survived Tca8113 cells. Transfection of Tca8113 cells with miR-203 mimics greatly reduced PIK3CA expression and Akt activation. Furthermore, miR-203 repressed PIK3CA expression through targeting the 3′UTR. Restoration of miR-203 not only suppressed cell proliferation, but also sensitized cells to cisplatin induced cell apoptosis. This effect was absent in cells that were simultaneously treated with PIK3CA RNAi. In summary, these findings suggest miR-203 plays an important role in cisplatin resistance in OSCC, and furthermore delivery of miR-203 analogs may serve as an adjuvant therapy for OSCC.
•Much lower miR-203 expression in cisplatin resistant Tca8113 cells is discovered.•Delivery of miR-203 can sensitize the Tca8113 cells to cisplatin induced cell death.•MiR-203 can downregulate PIK3CA through the 3′UTR.•The effects of miR-203 on cisplatin sensitivity is mainly through PIK3CA pathway.
Background
“Depth of invasion” is an additional index incorporated in 8th AJCC staging system for oral cavity squamous cell carcinoma based on its prognostic significance. Pre‐operative assessment by ...clinical palpation and imaging modalities has been used with limitations. The aim of the study is to compare different techniques including clinical palpation, ultrasound, and magnetic resonance imaging with histopathology for assessment of depth of tumor invasion.
Materials
Fifty patients of carcinoma tongue (T1–T3) were enrolled. Clinical palpation, Ultrasound tongue, and Magnetic resonance imaging were used to assess depth of tumor invasion. Microscopic depth of invasion was considered as reference. Statistical analysis was done to assess the level of agreement, reliability, and internal consistency. ROC analysis was done to find the “Area Under Curve” for microscopic depth versus ultrasound, MRI, and gross histopathological “depth of invasion”.
Results
Ultrasound tongue showed highest “area under curve”, Intra class correlation (ICC:0.786) with a good consistency (Cronbach's Alpha:0.880) with histological reference compared to MRI(ICC:0.689;CA:0.816). Clinical palpation showed weak agreement (Kappa:0.43) for assessing depth. To observe the concordance between ultrasound and microscopic depth, Lin's Concordance Correlation Coefficient (CCC = 0.782) was calculated with 95% limits of agreement. Lin's concordance correlation between ultrasound and microscopic depth showed a good agreement.
Conclusions
Ultrasound tongue is a reliable imaging modality for pre‐operative T staging by assessing tumor “depth of invasion” in carcinoma tongue patients with good internal consistency as per 8th AJCC staging system.
Level of Evidence
2 (CEBM‐Level of Evidence‐2.1) Laryngoscope, 134:215–221, 2024
Depth of invasion is new parameter add in 8th AJCC staging system for Oral cavity squamous cell carcinoma in clinical T staging. Accurate assessment is paramount for both staging and prognostication. Our study showed USG tongue is reproducible and reliable method which is quick, repeatable before surgery and cost‐effective.
Resection of primary in carcinoma tongue is challenging as the tumor often spreads submucosal and deep in muscles. There are various Intraoperative tools available to guide tumor resection margins. ...We studied the use of intraoperative ultrasound-guided resection for obtaining free deep resection margins in cases of oral carcinoma tongue. To assess the feasibility of resection of tongue tumor using intraoral ultrasound intraoperatively. 5 patients of oral tongue squamous cell carcinoma were included in this prospective pilot study. Intraoral ultrasound-guided resection of the primary tongue tumor was done. The surgeon moved the probe over the tumor and focussed on the point of maximum invasion by the tumor. A 26 G needle was passed in the tongue at a point that was 10 mm away from the deepest point of infiltration. It marked the deepest plane of resection. Following the above marking, a resection of tumor was done. Deep surgical resection margin was found to be >5 mm (free) in all the USG-guided surgically resected primary tongue tumors on histopathological examination. We have found intraoperative ultrasonography a useful tool for the surgical resection of primary tongue tumours.
Schwannomas commonly occur in the head and neck but infrequently involve the oral cavity and rarely afect the tongue. In this observation, the clinical and pathologic characteristics of a rare case ...of schwannoma of the tongue was evaluated.
A rare case of schwannoma of the tongue was evaluated.
A 29-year-old man, without any significant medical history was referred to our Department of Otolaryngology and Cervicofacial Surgery at the Salah Azaiez Institute for evaluation of a mass in the tongue. .
Clinically, the patient presented with a lingual mass noted to be slowly increasing in size. He reported associated tongue pain localized to the lesion. The duration of symptoms was 12 months. Examination revealed a 1,5 cm mass on the right lateral part of the tongue.
It had semielastic consistency, is movable, causes pain when touched, and is covered by a nonulcerated mucosa. No radiologic investigations were needed because the mass was easily seen and palpable.
An excisional biopsy was done under general anesthesia by transoral approach. The entire lesion was removed completely from the tongue using blunt dissection.
There were no perioperative and postoperative complications, and there was no need for nasogastric tube insertion postoperatively. Tissue was sent for histopathologic examination.
On gross examination, the histopathologic examination reveals a well-defined neoformation surrounded by fibrous connective tissue in a capsule-like form where remains of nerve endings. There is no mitotic activity. The final diagnosis was a benign schwannoma.
The postoperative outcome was uneventful, with no signs of recurrence even after two years.
Although schwannomas are often asymptomatic, given enough time, they can cause significant health issues such as significant dysphagia, dysarthria, and obstructive sleep apnea. The rarity of lingual schwannoma may explain the limited knowledge concerning these tumours. The treatment is exclusively surgical. The prognosis is excellent after resection, as malignant transformation is exceptional.
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