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PubMedDate not supplied

New tongue protector to prevent decubital lingual ulcers caused by tongue thrust with myoclonus.

We treated tongue ulcers in a twenty-two-month-old male child with Gaucher disease and several neuronopathic symptoms, including frequent convulsions. Because the patient was always thrusting his tongue and biting with his upper and lower primary incisors during the myoclonus and convulsions, traumatic decubital ulcers on the dorsum and ventral surface of the tongue were formed. During the convulsions, bleeding and pus discharges were observed. For the protection of the tongue from the teeth, a tongue protector was fabricated from a soft silicone relining material used for dentures. The protector covered the mandibular primary central incisors, the alveolar ridge, and the ventral surface, apex and dorsum of the tongue. The ulcer symptoms completely disappeared after two months of using the protector.

Dental Care for Chronically Ill↗

PubMed2007

Clinicopathologic significance of EpCAM expression in squamous cell carcinoma of the tongue and its possibility as a potential target for tongue cancer gene therapy.

Epithelial adhesion molecule (EpCAM) is a transmembrane glycoprotein involved in intercellular adhesion. In particular, EpCAM appears to be overexpressed by the majority of human epithelial carcinomas, including colorectal, breast, head and neck, and hepatic carcinomas. We therefore hypothesized that EpCAM would be a good molecular target for cancer gene therapy. EpCAM protein expression in 48 primary tongue cancers and 10 normal oral mucosa was evaluated using anti-EpCAM immunohistochemistry, and correlation was examined with the clinicopathologic factors. In four human tongue cancer cell lines (SAS, HSC-2, OSC19 and OSC20), we investigated EpCAM expression by reverse transcription-polymerase chain reaction (RT-PCR). The invasive potential of cancer cells was evaluated using Matrigel invasion assay. Moreover, the effect of EpCAM inhibition was analyzed using RNA interference (RNAi). EpCAM overexpression was detected in 30 of 48 tongue cancers (62.5%), and was significantly higher in primary squamous cell carcinoma (SCC) of the tongue than in normal oral mucosa. The expression of EpCAM was significantly associated with tumor size, regional lymph node metastasis, histological differentiation and invasion pattern. Cancer cell lines with higher EpCAM expression had more invasive potential. Moreover, RNAi-mediated EpCAM reduction decreased the invasion potential and proliferation activity. These results indicated that the overexpression of EpCAM was correlated with a more aggressive phenotype of tongue cancer. Moreover, we suggested that EpCAM could be a molecular target, and that RNAi targeting EpCAM could be useful for tongue cancer gene therapy.

Aged↗

PubMed2002

Continuous selective intraarterial chemotherapy in combination with irradiation for locally advanced cancer of the tongue and tongue base.

We retrospectively evaluated the results of the concurrent combination therapy of selective continuous intraarterial chemotherapy and radiotherapy in 39 patients with locally advanced cancer of the tongue and tongue base between September 1992 and January 2000. Thirty patients were fresh cases (stage II, 10 patients; stage III, 15; stage IV, five) and nine were recurrent cases. The primary lesion was present in the mobile tongue in 33 patients and the tongue base in six. External irradiation (median dose, 48.6 Gy) was performed in all patients, and interstitial brachytherapy using an Au grain or Cs needle (median dose, 50 Gy) in 21. In intraarterial chemotherapy, a catheter was selectively inserted into the lingual artery via the superficial temporal artery, and carboplatin (CBDCA) was continuously infused (median dose, 460 mg/m(2)) concurrently with radiotherapy. In 13 patients with cervical lymph node metastasis, two courses of systemic chemotherapy with 5-FU (700 mg/m(2) x 5 days) and cisplatin (40-50 mg/m(2)x2 days) or its analog was also performed. In 37 (94.9%) of the 39 patients in whom this combination therapy was completed, the response rate was 94.6%. The 3-year local control rate, progression-free survival rate, and overall survival rate by Kaplan-Meier's method were 79.2, 53.2, and 58.9%, respectively. This combination therapy was effective for locally advanced cancer of the tongue and tongue base without causing severe adverse side effects, and a local control rate comparable to that by surgery can be expected.

Adult↗

PubMed1980

Tongue strength: its relationship to tongue thrusting, open-bite, and articulatory proficiency.

Maximum protrusive tongue strength was measured for two experimental groups of 35 normal speaking children and 21 children with frontal lisping, anterior tongue thrusting during swallow, and open-bite malocclusion, and a control group of 85 children with normal speech and occlusion who did not thrust their tongues during swallow. No significant differences in tongue strength were found among these groups. The findings were interpreted to support the view that tongue strengthening exercises recommended by some authors for the correction of tongue thrusting or associated frontal lisping may be superfluous.

Adolescent↗

PubMed1998

Nuclear DNA content and p53 overexpression in stage I squamous cell carcinoma of the tongue compared with advanced tongue carcinomas.

AIMS: To evaluate the predictive value of the nuclear DNA content (image cytometry) and p53 overexpression (immuno-histochemistry using antibody CM-1) in uniformly treated stage I carcinomas of the mobile tongue. Also, to compare stage I carcinomas with advanced tongue carcinomas (stages II-IV). METHODS: Archival formalin fixed, paraffin wax embedded tumour specimens from 54 patients with stage I squamous cell carcinoma and 37 patients with advanced squamous cell carcinoma were analysed. Mean follow up time of the stage I carcinomas was 71 months (median, 62.5; range, 6-175). RESULTS: Twenty three patients (stage I) had recurring disease: 10 had local recurrence (in the tongue) and 13 had regional recurrence (cervical metastases). Locally recurring stage I carcinomas had a more pronounced DNA deviation than the other stage I carcinomas and this degree of deviation was comparable with the DNA content of advanced carcinomas. Stage I carcinomas that developed regional recurrences overexpressed p53 more frequently. In Cox multivariate regression analysis of time to recurrence, DNA deviation was a significant parameter in tumours that recurred locally (p = 0.032). p53 overexpression was the only parameter close to significance for regional recurrence (p = 0.065). CONCLUSIONS: Nuclear DNA content and p53 immunostaining are of value for the prediction of recurrence of stage I squamous cell carcinomas of the mobile tongue. Stage I tongue carcinomas that are prone to local recurrence show the same DNA content as do advanced tongue carcinomas.

Adult↗

PubMed2002

[Platysma myocutaneous island flap reconstruction after excision of a tongue-tongue base tumor].

The authors' aim was to introduce a simple, safe and reliable method for reconstruction of soft tissue defects after excision of carcinomas of the tongue, tongue base and posterior part of the floor of the mouth. The musculocutaneous flaps are options of larger soft tissue defects in the maxillofacial area. After excision of a tongue-tongue base tumour with mandibular splitting method a platysma myocutaneous flap was applied for reconstruction. The flap was taken from an appropriate place convenient to functional acceptions and was adapted anatomically into the defect. The result was that the patient healed primarily with undisturbed blood circulation of the flap. The functional rehabilitation period was short, the flap tolerated the irradiation. The authors observed that the use of the platysma island flap can be an option for reconstruction of defects after ablative surgery on the tongue-tongue base. This simple method worked reliable even after intra-arterial cytostatic treatment. The acceptable functional result depends on the placement of the island flap on the neck flap prepared for neck dissection.

Adult↗

PubMed1977

[Tongue as a reflector of cerebral and articulatory dysfunction. Tongue motility test for three- to five-year-old children].

The tongue motility test has been developed to test the motility of the tongue in three- to five-year-old preschool children. It examines the resting position of the tongue and the mobility of the tongue in relation to 9 different movement patterns of varying degrees of difficulty. The result of the test is represented by the number of points obtained (minimum = 0, maximum = 10). The results of a routine investigation of 865 children provide the normal value for the tongue motility test. This is especially related to the age and less to the sex of the subject. The significance of the tongue motility test for the diagnosis of "minimal cerebral dysfunction" and for the investigation of the stage of articulatory development of a child is discussed.

Attention Deficit Disorder with Hyperactivity↗

PubMed1998

Risk assessment of tobacco, alcohol and diet in cancers of base tongue and oral tongue--a case control study.

This is a retrospective case-control study of male tongue cancer patients seen at Tata memorial Hospital, Bombay, during the years 1980-84. The purpose of the study was to identify the association of tobacco, alcohol, diet and literacy status with respect to cancers of two sub sites of tongue namely anterior portion of the tongue (AT) (ICD 1411-1414) and base of the tongue (BT) (ICD 1410). There were 142 male AT patients and 495 BT patients interviewed during the period. 635 interviewed male patients who were free of any disease were considered as control. Bidi smoking was found to be a significant risk factor for BT patients and tobacco chewing for AT patients respectively. Alcohol drinkers showed about 45% to 79% excess risk for both sites of tongue cancer. Illiteracy and non vegetarian diet proved to be a significant factor for AT patients only. The study brings out that the location of cancer has got a direct bearing with the type of tobacco use and other related habits and this inturn may provide meaningful interpretation of variations observed in the incidence of tongue cancer around the world.

Adult↗

PubMed2003

[Modified set back tongue flap: an alternative surgical approach in the reconstruction of defects of the base of the tongue].

The base of the tongue after tumor resection can be reconstructed in several ways. In addition to direct suturing of small defects, a variety of local or microvascularly anastomosed flaps have been described. The present paper is aimed at introducing a local tongue flap for the reconstruction of medium-sized defects. Six patients were treated at the hospital between 1999 and 2002 with the above technique to cover defects affecting one-half to three-fourths of the base of the tongue. One patient had secondary bleeding and the other one experienced no complications. Nutrition could be started after 7.5 days (4-12) postoperatively on average. The tracheostomy was closed at 16.2 days (12-22) on average after the initial operation. The hospitalization of the patients was 20.3 days (15-27) on average. The modified set back tongue flap is an alternative in the reconstruction of subtotal defects of the base of the tongue. Easy handling, good functional outcome in swallowing, and the low complication rate were advantageous in the present series.

Adult↗

PubMed1989

The second carcinoma of the anterior two-thirds of the tongue after successful radiotherapy to the tongue.

Of 221 patients with carcinoma of the mobile tongue treated by radiotherapy, 129 survived without local recurrence for 5 years or longer after initial treatment. These 129 patients were studied to determine the incidence of second carcinoma of the tongue which first appeared more than 5 years after the initial treatment. Modalities of irradiation were radium needle implantation and intraoral electron irradiation for 105 and 24 patients, respectively. Twenty-two of the patients were found to have second carcinoma of the tongue. The incidence appeared to increase as the amount of radiation given increased. No obvious relationships were observed between the second carcinoma and modality of irradiation, T classification, presence of leukoplakia before the treatment, degree of histological differentiation, or degree of radiation injury. There were moderate to severe radiation injuries in 50% of the patients treated by radium needle implantation. It is likely that most of the second carcinomas of the tongue represent the late appearance of one of the multicentric foci of the tumor, not a regrowth of the residual primary tumor. In spite of the rather high rate of second carcinoma of the tongue, radiotherapy remains an excellent modality of treatment when patients are properly selected.

Brachytherapy↗

PubMed2001

Functional reconstruction of mobile tongue and suprahyoid muscles after resection of cancer of the tongue.

The mobile tongue and the suprahyoid muscles were reconstructed in a man who had had a total resection of the mobile tongue with the oral floor and bilateral radical neck dissection (extensive resection of the bilateral suprahyoid muscles) for cancer of the tongue. A rectus abdominis musculocutaneous flap with the tenth intercostal nerve anastomosed to the remaining hypoglossal nerve was used for the reconstruction. The rectus abdominis muscle was inserted between the mandible and the hyoid bone, taking account of the anatomical positions of the tongue and suprahyoid muscles; the rectus sheath was then firmly sutured to the mandible and hyoid bone. This procedure created firm tendinous insertions between the mandible and hyoid bone. After the operation, the reconstructed tongue showed no sign of atrophy, and the reconstructed supra-hyoid muscles (rectus abdominis muscle) could be moved, and the hyoid bone could be raised.

Carcinoma, Squamous Cell↗

PubMed1981

Contraction times of the cat's tongue muscles measured by light reflection. Innervation of individual tongue muscles.

The contraction times of the cat's tongue muscles were measured by recording the fine movements of their surfaces and movements of the tongue's surfaces. The recordings were made by means of a commercial, high-sensitive light reflection transducer (Fairchild FPLA 850) which could be operated without any mechanical loading of the tongue. The contraction times of the intrinsic muscles (including pars longitudinalis superior m. hypoglossi and pars longitudinalis inferior m. styloglossi) measured about 22 ms, while the extrinsic muscles were somewhat slower, around 33 ms. The data are considered in the light of the recently reported histochemical composition of these muscles. The study of the hypoglossal nerve supply to individual tongue muscles revealed that, contrary to earlier reports, the medial nerve sends branches to the intrinsic muscles not only at its distal end but during its entire course through the tongue. The transversal and vertical muscles were found to receive numerous fibers innervating small units of their muscle fibers.

Animals↗

PubMed1980

Set-back tongue flap for carcinoma of the tongue base.

Carcinoma of the base of the tongue has been treated with various combinations of radiotherapy and surgery. Resection of this area poses a major problem in reconstruction because of the need for establishing normal physiologic characteristics. This article emphasizes the benefits of a lateral pharyngotomy and mandibulotomy for resection of large portions of the tongue base. We describe a tongue flap with a neurovascular pedicle that is set back into the tongue-base deficit. This one-stage procedure is relatively easy to perform and provides good physiologic results.

Aged↗

PubMed1991

Is fetal cellular rhabdomyoma an entity or a differentiated rhabdomyosarcoma? A study of patients with rhabdomyoma of the tongue and sarcoma of the tongue enrolled in the intergroup rhabdomyosarcoma studies I, II, and III.

A tumor of the tongue with features consistent with the diagnosis of fetal cellular rhabdomyoma was seen in an 18-month-old infant. The tumor recurred 10 and 22 months after initial resection. The histologic condition of the first recurrence was similar to the original tumor except for some increased nuclear irregularities and mitotic activity. No adjunctive therapy was administered initially or after the first recurrence. The second recurrence showed mixed embryonal/alveolar rhabdomyosarcoma. This case represented a unique model of a highly differentiated striated muscle tumor converting to a moderately differentiated rhabdomyosarcoma, and illustrated differential diagnostic difficulties in distinguishing between fetal cellular rhabdomyoma and differentiated rhabdomyosarcoma. The patient was compared with eight children and adolescents with primary sarcomas of the tongue who entered the Intergroup Rhabdomyosarcoma Studies (IRS) I, II, and III protocols. The tumors of all eight arose at the base of the tongue. There were five embryonal, one alveolar, and one mixed embryonal/alveolar rhabdomyosarcomas, and one undifferentiated myxoid sarcoma. Five rhabdomyosarcomas were poorly differentiated, and two had a moderate degree of myogenesis. These sarcomas of the tongue represent approximately 0.34% of all cases entered in IRS studies.

Biopsy↗

PubMed1985

Tongue thrust, tongue tip position at rest, and sigmatism: a review.

This article reviews the available evidence regarding the incidence of tongue thrust swallowing and the possible relation between this deglutition pattern, tongue tip position at rest, and sigmatism. It is found that tongue thrust swallowing a) is the rule rather than the exception in children under 10 years of age, b) is not correlative with low tongue tip position at rest, c) is not closely linked up with dental malocclusion, and d) does not prevent, but may delay, the acquisition of correct sibilant articulation.

Adolescent↗

PubMed2005

[Expression of cyclooxygenase-2 and inducible nitric oxide synthase in tongue hyperplasia and tongue squamous cell carcinoma].

BACKGROUND & OBJECTIVE: Recently, it has been recognized that both cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) produce important endogenous factors of human tumor progression. However, the biological significance of the adnormal expression of COX-2 and iNOS in tongue squamous cell carcinoma remains unclear. This study was to investigate the expression of COX-2 and iNOS in tongue squamous cell carcinoma and precancerous lesions, and analyze their interrelation. METHODS: The expression of COX-2 and iNOS in 59 specimens of tongue squamous cell carcinoma (SCC), 45 specimens of hyperplasia (22 cases of mild hyperplasia, 20 cases of moderate hyperplasia, and 3 cases of severe hyperplasia), and 36 specimens of pericancerous normal epithelium was detected by SP immunohistochemistry. RESULTS: The positive rates of COX-2 were 8.3% in normal epithelium, 4.5% in mild hyperplasia, 5.0% in moderate hyperplasia, 0 in severe hyperplasia, and 45.8% in SCC, respectively; those of iNOS were 44.4% in normal epithelium, 72.7% in mild hyperplasia, 80.0% in moderate hyperplasia, 100% in severe hyperplasia, and 98.3% in SCC, respectively. The positive rates of COX-2 and iNOS were significantly higher in SCC than in normal epithelium (P < 0.001); the positive rate of iNOS was also significantly higher in hyperplasia than in normal epithelium (P < 0.001). The overexpression of COX-2 and iNOS was positively correlated with pathologic grade of the lesions (r = 0.418, P < 0.001; r = 0.607, P < 0.001). COX-2 expression was positively correlated with iNOS expression (r = 0.245, P < 0.001). CONCLUSOIN: The overexpression of COX-2 and iNOS is closely related to the carcinogenesis of the tongue.

Adult↗

PubMed1976

Scrotal tongue and geographic tongue: polygenic and associated traits.

The familial nature of scrotal and geographic tongue was investigated in parents and siblings of 156 probands having these conditions. The prevalence in parents and siblings was significantly higher than that in the control populations. The prevalence in sibilings from families in which at least one parent was also affected was significantly higher than that in siblings from families in which neither parent was affected. The prevalence of scrotal tongue alone in siblins was similar irrespective of the condition in the proband. The prevalence of geographic tongue alone was highest in siblins of probands having only geographic tongue. A polygenic mode of inheritance with some genes common to both conditions is suggested.

Adolescent↗

PubMed2006

Ablation of advanced tongue or base of tongue cancer and reconstruction with free flap: functional outcomes.

AIM: To evaluate the functional outcomes of patients who underwent total or nearly total glossectomy for advanced tongue or base of tongue cancer. MATERIAL AND METHODS: We used the radial forearm free flap (RFFF), anterior lateral thigh flap (ALTF) or fibular osteocutaneous flap (FOCF) to reconstruct the oral defect after radical resection in 39 patients undergoing total or nearly total glossectomy with laryngeal preservation. RESULTS: Good functional outcomes, measured by independent feeding, speech and swallowing were achieved in 35, 36 and 35 patients, respectively. The cumulative 4-year survival rates were 63.8% for tongue cancer and 42.9% for base of tongue cancer. CONCLUSION: Reconstruction with free flaps is a feasible method to restore the functional outcomes in speech and deglutition among patients who undergo total or nearly total glossectomy with laryngeal preservation.

Adult↗