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Jurkiewicz BDZ. Rare case of pyogenic granuloma of the tongue in an 8-week-old infant. Eur Arch Otorhinolaryngol 2004; 262:453-5. [PMID: 15549337 DOI: 10.1007/s00405-004-0845-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2004] [Accepted: 07/22/2004] [Indexed: 10/26/2022]
Abstract
We present a case of a large pyogenic granuloma of the tongue causing swallowing difficulties in an 8-week-old infant. In the literature, we found no case reports of pyogenic granuloma in such a young infant. It is a quickly growing, hypertrophic inflammatory change consisting of exceptionally richly vascularized granular tissue. The granuloma was located in the central part of the tongue and appeared dark pink in color. It was an easily bleeding pedunculated tumor measuring 3 x 2.5 cm. The etiology of the tumor is unknown; it can arise in sites of previous injury, chronic irritation and infection. The course of the disease is benign and painless, though it can be recurrent. No recurrence was found in the control examination after 3 years.
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Brinkmann S, Reilly S, Meara JG. Management of tongue-tie in children: a survey of paediatric surgeons in Australia. J Paediatr Child Health 2004; 40:600-5. [PMID: 15469527 DOI: 10.1111/j.1440-1754.2004.00483.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To explore the beliefs and practices of Australian surgeons regarding surgical intervention to release tongue-tie and to determine the main referral sources. In addition, we aimed to ascertain if there were differences in beliefs and practices according to surgical specialty. METHODS Four hundred surgeons in three different surgical specialties were surveyed via questionnaire. Multiple choice response questions and open ended questions were used to explore beliefs and practices surrounding tongue-tie assessment, management and follow up. The questionnaires were distributed by email (where available), followed by fax and mail. RESULTS A response rate of 80.8% (n = 323) was obtained. Of these, 236 (73%) reported they practised surgery to release tongue-tie; 46% were oral and maxillofacial surgeons, 37% were plastic surgeons and 17% were paediatric general surgeons. Indications for surgical management and follow up varied according to surgical specialty. There was no clear consensus regarding clinical indicators for surgery or functional outcomes following surgery. CONCLUSIONS It appears that until a prospective study designed to address some of the controversial issues outlined is undertaken, we will remain ignorant about the need for surgery to release tongue-tie in children.
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Donnelly LF, Shott SR, LaRose CR, Chini BA, Amin RS. Causes of persistent obstructive sleep apnea despite previous tonsillectomy and adenoidectomy in children with down syndrome as depicted on static and dynamic cine MRI. AJR Am J Roentgenol 2004; 183:175-81. [PMID: 15208134 DOI: 10.2214/ajr.183.1.1830175] [Citation(s) in RCA: 163] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Our purpose was to evaluate the causes of persistent obstructive sleep apnea despite previous tonsillectomy and adenoidectomy in children with Down syndrome as depicted on cine MRI. MATERIALS AND METHODS Cine MRI studies performed to evaluate persistent obstructive sleep apnea despite previous tonsillectomy and adenoidectomy were reviewed. MRI was performed under sedation and included cine MR images (fast gradient-echo) obtained in the midline sagittal plane and in the axial plane at the base of the tongue and T1-weighted spin-echo and fast spin-echo inversion recovery images in the axial and sagittal planes. Imaging parameters reviewed included static and dynamic diagnoses made, frequency of recurrence and diameter of tonsillar tissue, and tongue morphology. RESULTS Twenty-seven patients were identified (mean age, 9.9 years). Diagnoses included glossoptosis in 17 patients (63%), hypopharyngeal collapse in six (22%), recurrent and enlarged adenoid tonsils in 17 (63%), enlarged lingual tonsils in eight (30%), and macroglossia in 20 (74%). Of the 20 patients with macroglossia, 11 (55%) had absence of the normal median sulcus and 12 (60%) had evidence of fatty infiltration of the tongue musculature. CONCLUSION Persistent obstructive sleep apnea in children with Down syndrome who have undergone previous adenoidectomy and tonsillectomy has multiple causes. The most common causes include macroglossia, glossoptosis, recurrent enlargement of the adenoid tonsils, and enlarged lingual tonsils.
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Reiss M, Reiss G. [Burning mouth syndrome--etiology, differentialdiagnostical aspects and therapy]. THERAPEUTISCHE UMSCHAU 2004; 61:308-12. [PMID: 15195716 DOI: 10.1024/0040-5930.61.5.308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Burning Mouth Syndrome (BMS) or glossodynia is a chronic pain syndrome that mainly affects middle-aged/elderly women. This condition is probably of multifactorial origin, often idiopathic, and its etiopathogenesis remains largely enigmatic. Visible pathologic lesions of the oral mucosa or processes are usually not evident. Etiologic factors that have been reported include several disorders (e. g. hematologic disorders, denture factors, the climacteric, infections, endocrinological, neurological or psychiatric disorders). On the other hand psychological factors, such as anxiety, depression and phobias have been reported to play a significant role at the beginning of this nosological entity. BMS related to nutritional deficiency is uncommon. A systemic approach to assessment is essential and the opinion of other specialities, particularly internal medicine, dentistry or neurology, may be of help. Treatment is of the underlying cause but in many cases no specific aetiological factor is identified. Non-indicated substitution therapy of suspected but unproved deficiency states must be avoided. Treatment approaches were divided into topical and systemic strategies. However, there is little research evidence that provides clear guidance for those treating patients with BMS.
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Tincani AJ, Martins AS, Del Negro A, Araújo PPC, Barretto G. Lingual thyroid causing dysphonia: evaluation and management. Case report. SAO PAULO MED J 2004; 122:67-9. [PMID: 15257363 DOI: 10.1590/s1516-31802004000200007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
CONTEXT Lingual thyroid gland is a rare clinical entity that is caused by the failure of the thyroid gland to descend to a normal cervical location during embryogenesis. The occurrence of an ectopic thyroid gland located at the base of the tongue may cause problems for the patient, with symptoms of dysphagia, dysphonia, upper airway obstruction or even hemorrhage at any time from infancy through adulthood. CASE REPORT We report on a case of lingual thyroid gland in a 41-year-old female patient. The embryology and diagnosis of ectopic thyroid are discussed and its management is outlined. Features of the diagnostic and therapeutic evaluation are described with attention to the clinical findings, laboratory tests, thyroid scan and computed tomography imaging studies employed in the confirmation of diagnosis and planning of appropriate treatment. The history of the condition is reviewed and a treatment strategy is outlined. Surgical excision of the gland is reserved for cases of gland enlargement that result in compromised airways (dysphagia or dysphonia) or recurrent hemorrhage.
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Torres R, Cottrell D, Reebye UN. Ulcerative tongue lesion secondary to cytomegalovirus. JOURNAL OF THE MASSACHUSETTS DENTAL SOCIETY 2004; 53:36-7. [PMID: 15503940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Just T, Gafumbegete E, Kleinschmidt EG, Pau HW. [Contact endoscopic quantification of fungiform papillae--correlation to taste ability?]. Laryngorhinootologie 2003; 82:501-7. [PMID: 12886498 DOI: 10.1055/s-2003-40897] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Besides anamnestic data and taste test, the clarification of epithelial taste disorders makes macroscopic evaluation of the surface of the tongue necessary. METHODS In this article the contact endoscopy is evaluated for examination of the tongue epithelium and for quantification of the fungiforme papillae. These results are related to the results of the spatial taste test (1. chemical taste test with sodium chloride in 2 different suprathreshold concentrations and sucrose in also 2 different suprathreshold concentrations; 2. electrogustometry with a bipolar electrode). PATIENTS In a prospective study we performed contact endoscopy in 16 healthy volunteers from ages 7 to 68 years. The subjects were divided into 2 age groups (< or = 45 years and > 45 years) and 2 papillae density groups. In 34 patients with either taste disorders of unknown cause or in patients with macroscopic changes at the tongue surface, the spatial and whole mouth taste tests and contact endoscopy were used to clarify the cause of the complaints. RESULTS Density and shape of the fungiform papillae as well as the shape of the subepithelial vessels of the papillae vary among the investigated human subjects in the different age groups. No correlation between intensity ratings, papillae density und age was found after stimulation with 40 % sucrose at the tongue tip in the younger age group. Stimulation of the tongue edge with 15 % sodium chloride, however, showed a relationship between the two different density groups and the different age groups. CONCLUSIONS The contact endoscopy allows the evaluation of the epithelium in the oral cavity. It is a nondestructive method and is additionally easy to handle, but the evaluation of the observed epithelia needs interdisciplinary co-operation with pathologists. No relevant informations are supplied in diagnostics of taste disorders.
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Pérez JS, Muñoz M, Naval L, Blasco A, Diaz FJ. Papillary carcinoma arising in lingual thyroid. J Craniomaxillofac Surg 2003; 31:179-82. [PMID: 12818605 DOI: 10.1016/s1010-5182(03)00032-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Lingual thyroid is a well-known developmental abnormality, malignant transformation of which is rare. This is a case report of a papillary carcinoma located in ectopic lingual thyroid tissue, in a 28-year-old white male. A search of the literature revealed only one more such report.
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Agarwal P, Raina VK. Tongue-tie: an update. Indian Pediatr 2003; 40:404-5. [PMID: 12768041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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Martinello RA, Cooney EL. Cerebellar brain abscess associated with tongue piercing. Clin Infect Dis 2003; 36:e32-4. [PMID: 12522766 DOI: 10.1086/345755] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2002] [Accepted: 10/08/2002] [Indexed: 11/03/2022] Open
Abstract
We describe a previously healthy adult who had a solitary cerebellar brain abscess diagnosed. This infection occurred 4 weeks after the patient underwent a tongue piercing procedure that was complicated by an apparent local infection. The clinical history, abscess culture results, and lack of an alternative explanation suggest that infection of the tongue piercing site was the source of the cerebellar abscess.
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Tomb R, El-Hajj H, Nehme E, Haddad A. [Verrucous carcinoma of the tongue occurring on lesions of lichen planus]. Ann Dermatol Venereol 2003; 130:55-7. [PMID: 12605160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND Verrucous carcinoma of the oral cavity is a rare entity that was formerly controversial. Etiopathogenesis remains unclear, notably as for its possible association with lichen planus. We report a case of verrucous carcinoma occurring in lesions of lichen planus of the tongue. CASE REPORT A 78-year old, non smoking patient, with past history of cutaneous lichen planus presented for lesions of oral lichen planus affecting both the tongue and the palate. A treatment by topical tretinoin improved him in a spectacular way and brought about a remission which lasted 5 years. A recurrence occurred when the treatment was stopped; new whitish, warty cauliflower-like lesions appeared on the tongue. A biopsy confirmed the clinical suspicion of verrucous carcinoma. A laser resection was performed. Three months later, another recurrence was observed. A chemotherapy associating isotretinoin and methotrexate eliminated all lesions. The patient's condition is considered stable, under treatment, one year later. DISCUSSION Verrucous carcinoma is a rare slow-growing oral tumor that is chiefly exophytic and does not metastasize, but it can invade and destroy oral tissues. Its clinical presentation contrasts with benign histologic features: papillomatosis, acanthosis, dysplasia in variable degrees. The occurrence on lesions of lichen planus, although "classic", is very rarely found in the literature. The treatment is not well codified. An additional chemotherapy seems necessary to prevent recurrences.
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Abstract
OBJECTIVE We wanted to determine whether ankyloglossia is associated with articulation problems and the effect of frenuloplasty on speech and tongue mobility. STUDY DESIGN We conducted a prospective study of 30 children aged 1 to 12 years with ankyloglossia undergoing frenuloplasty. Outcomes were assessed by measurements of tongue mobility, speech evaluation, and parent questionnaires. RESULTS Mean tongue protrusion improved from 14.2 mm preoperatively to 25.8 mm postoperatively (P < 0.01). Similarly, mean tongue elevation improved from 5.2 to 22 mm (P < 0.01). Preoperative speech pathology evaluation documented articulation problems thought due to ankyloglossia in 15 of 21 children. Postoperative evaluation in 15 of these children showed improvement in articulation in 9, no change in 4 who had normal speech preoperatively, and an ongoing articulation disorder in 2. Parent perception of speech intelligibility on a scale of 1 to 5 improved from 3.4 to 4.2 (P < 0.01). CONCLUSION Tongue mobility and speech improve significantly after frenuloplasty in children with ankyloglossia who have articulation problems.
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Stratmann G, Benumof JL. Near tracheal extubation because of edema of the face and tongue. Anesth Analg 2002; 95:1809-11, table of contents. [PMID: 12456463 DOI: 10.1097/00000539-200212000-00063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
IMPLICATIONS Edema of the face and tongue can cause migration of the endotracheal tube out of the trachea. The present case illustrates the importance of preventing this potentially disastrous complication because reintubation might be impossible when the edema is severe.
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Vandekerckhove B, van Steenberghe D. [The role of periodontal diseases in bad breath]. Ned Tijdschr Tandheelkd 2002; 109:430-3. [PMID: 12494703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
The majority of bad breath originates within the oral cavity. However, it is also possible that it is caused by other extra-oral sources. Ear-nose-and-throat causes and systemic diseases, such as diabetes mellitus, uremia, liver failure, pulmonary carcinoma, bronchiectasis, are the most frequent problems. In 65-85% of the cases of bad breath, we find the cause in the parodontium and/or tongue. Components from tongue coating and periodontal pockets circulate through the saliva in the whole oral cavity and also reach the tonsils.
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Abstract
A case of microcephaly associated with traumatic ulceration to the ventral surface of the tongue (Riga-Fede disease) in a 12-month-old female is presented. To the best of our knowledge, such association has not been described previously. A conservative treatment regime was used, involving medical management, elimination of the sharp edges of the teeth and use of topical triamcinolone, and the ulceration healed over a period of 4 weeks.
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Yamashita S, Sato S, Kakiuchi Y, Miyabe M, Yamaguchi H. Lidocaine toxicity during frequent viscous lidocaine use for painful tongue ulcer. J Pain Symptom Manage 2002; 24:543-5. [PMID: 12547053 DOI: 10.1016/s0885-3924(02)00498-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Oral viscous lidocaine is useful for the treatment of symptoms induced by oral inflamed mucosa, such as radiation- or chemotherapy-induced mucositis. The toxic reactions associated with an accidental overdose have been reported in pediatric cases. We report a case of lidocaine toxicity in a 22-year-old man during frequent viscous lidocaine use for severe painful tongue ulcer. The toxic symptoms developed when the amount of oral viscous lidocaine exceeded 240 ml per day. The serum lidocaine concentration associated with this use was 6.7 microg/ml. The toxic symptoms continued in spite of the serum lidocaine concentration below the toxic level after the start of a diluted preparation, which contained a half-dose lidocaine. It is speculated that lidocaine metabolites might have contributed to the toxic symptoms. Clinicians should consider the risk of lidocaine toxicity in cases of frequent viscous lidocaine use, and determine the serum concentrations of lidocaine and its metabolites.
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Chemaly RF, Fox SB, Alkotob LM, Scharpf J, Sobecks R, Eliachar I, Procop GW, Smith M, Avery RK, Schmitt SK. A case of zygomycosis and invasive candidiasis involving the epiglottis and tongue in an immunocompromised patient. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 2002; 34:149-51. [PMID: 11928855 DOI: 10.1080/00365540110077182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Invasive fungal infections are associated with high morbidity and mortality in immunocompromised patients. We describe an unusual case of concomitant invasive candidiasis and zygomycosis of the tongue and epiglottis that occurred in a young patient with neutropenia during chemotherapy for acute myelogenous leukemia and was successfully treated medically.
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Bridges MJ, Kelly CA. Raynaud's phenomenon affecting the tongue of a patient with scleroderma. Ann Rheum Dis 2002; 61:472. [PMID: 11959778 PMCID: PMC1754086 DOI: 10.1136/ard.61.5.472] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Aboulafia DM. Condyloma acuminatum presenting as a dorsal tongue lesion in a patient with AIDS. THE AIDS READER 2002; 12:165-7, 172-3. [PMID: 12071187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Oral lesions have been recognized as a prominent feature of HIV infection and AIDS since the beginning of the epidemic. This report describes the case of a man with advanced AIDS and a nonpainful but enlarging dorsal tongue soft tissue growth of 6 months' duration. Incisional biopsy showed a red, papillary lesion with koilocytosis consistent with condyloma acuminatum. In situ hybridization and molecular techniques were used to identify human papillomavirus (HPV)-31 sequences in warty tissue. Eighteen months later, the lesion recurred and was reexcised without complication. This case is reported to illustrate that venereal transmission may not be as important in warts of the oral cavity as in HIV-associated anogenital warts, because warts of the oral cavity are rarely associated with HPV types 6, 11, 16, and 18. Instead, they may be present as a result of activation of latent HPV infection or perhaps autoinfection from skin and facial lesions. The carcinogenic potential of oral warts in HIV disease is undefined, as is the role of antiretroviral therapy in controlling HPV-associated oral lesions.
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Gugle MM. Etiology, pathogenesis and treatment of habitual dislocations of the T.M. Joints [original work]. Indian J Dent Res 2002; 13:88-94. [PMID: 12420573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
Abstract
Definite treatment of any pathological condition, is based on the understanding of its correct pathogenesis and etiology. Without this basic understanding correct and lasting treatment is not possible. When there is no knowledge of exact pathogenesis and etiology, various theories and treatments are suggested by various workers. This is what exactly happened in the case of habitual dislocations of the T.M. Joints. This in term has happened because the dental surgeons and so called oral surgeons, never expanded their vision, beyond their restricted field of 20 deciduous teeth and 32 permanent teeth. Lack of understanding of basic physiological functions, of various tissues in the body and their effects on various systems as a whole was neglected. For this study four patients were selected from many, who could visit my clinic regularly and co-operate to follow all the instructions over a period of at least 5 years. The analysis of their symptoms and signs, had a different story to tell than what was described in the literature so far.
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Abdallah-Matta MP, Dubarry PH, Pessey JJ, Caron P. Lingual thyroid and hyperthyroidism: a new case and review of the literature. J Endocrinol Invest 2002; 25:264-7. [PMID: 11936471 DOI: 10.1007/bf03344002] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Lingual thyroid is the result of a defective migration of the thyroid anlage occurring between the 3rd and 7th week of gestation. Whereas mutations in the transcription factor-2 (TTF-2) and PAX8 and in the TSH receptor genes (TSH-R) have been reported in a minority of patients with thyroid dysgenesis, the etiopathogeny of the majority of cases, and in particular of thyroid ectopy, remains unclear. The majority of patients with thyroid ectopy are asymptomatic, but obstructive symptoms as well as hypothyroidism have been observed. Hyperthyroidism is an exceptionally rare finding. To our knowledge, only 2 cases have been reported in the literature to date. Herein, we describe an unusual case of thyrotoxicosis related to a nodular lesion in a lingual thyroid. Treatment consisted in restoration of a euthyroid state with thionamide followed by surgical removal of the ectopic gland. The underlying molecular cause of the ectopic lingual thyroid and the toxic adenoma in this case could not be identified. We speculate that abnormally early differentiation of the thyroid gland could interfere with the migration process, a hypothesis yet to be confirmed.
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Cozzi F, Morini F, Casati A, Camanni D, Zani A, Cozzi DA. Glossopexy as an alternative to aortopexy in infants with repaired esophageal atresia and upper airway obstruction. J Pediatr Surg 2002; 37:202-6. [PMID: 11819199 DOI: 10.1053/jpsu.2002.30255] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND/PURPOSE Clinical manifestations of airway obstruction in infants with repaired esophageal atresia or tracheoesophageal fistula (EA/TEF) are attributed conventionally to tracheomalacia. In the current study, the authors tested the hypothesis that a retrodisplacement of the tongue (glossoptosis), by causing a functional upper airway obstruction (obstructive apnea/hypopnea), may play a role in the pathogenesis of the respiratory problems. METHODS The records of 5 infants with repaired EA/TEF and respiratory symptoms treated by glossopexy, which serves to anchor the tongue forward, were reviewed. Prompt improvement after glossopexy in clinical manifestations, in blood gas exchange, and in weight velocity was used to establish a primary cause-effect relationship between glossoptosis and respiratory problems. RESULTS Before glossopexy, all infants presented with severe respiratory distress. Three infants had life-threatening events requiring recurrent or chronic airway intubation. Four infants had severe tracheomalacia, diagnosed at bronchoscopy. All infants presented obstructive apnea/hypopnea with desaturation. Body weight was below the third percentile in all infants. After glossopexy, 3 presented a marked clinical improvement associated with significant increase in mean oxygen saturation (88% +/- 0.4 SE v 95% +/- 0.3 SE; P <.001). In another infant, glossopexy allowed permanent decannulation but did not relieve the problem during crying or excitement when obstructive hypopnea with desaturation required supplemental oxygen. After glossopexy and despite subsequent aortopexy, the last infant could not be extubated and died later of mycotic sepsis. Autopsy results showed a vascular ring. In the 4 surviving infants, glossopexy was followed promptly by significant catch-up growth and subsequent normal growth velocity (P =.03). CONCLUSIONS Present findings support the concept that, in some infants with EA/TEF, respiratory problems are mainly caused by recurrent obstructive apnea/hypopnea, which may be treated successfully by lip-tongue adhesion procedures. Severe airway obstruction, not relieved by glossopexy, requires aortopexy to reduce the respiratory load imposed by tracheomalacia.
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Camacho F, García-Bravo B, Carrizosa A. Treatment of Miescher's cheilitis granulomatosa in Melkersson-Rosenthal syndrome. J Eur Acad Dermatol Venereol 2001; 15:546-9. [PMID: 11843214 DOI: 10.1046/j.1468-3083.2001.00270.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cheilitis granulomatosa is the most frequent dermatological sign in the Melkersson-Rosenthal syndrome. We reviewed 27 cases of this syndrome diagnosed and treated in the last 20 years. All the patients were surgically treated and received intralesional corticosteroids during surgery and tetracycline hydrochloride (500 mg, twice daily) after the operation to prevent recurrence.
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Shaps HJ, Snyder GE, Sama AE, Rudolph GS. Airway compromise secondary to lingual hematoma complicating administration of tissue plasminogen activator for acute ischemic stroke. Ann Emerg Med 2001; 38:447-9. [PMID: 11574803 DOI: 10.1067/mem.2001.116615] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hemorrhagic complications of tissue plasminogen activator (tPA) are well known. We report a case of a lingual hematoma that developed after tPA administration for an acute ischemic stroke that necessitated orotracheal intubation to maintain the patient's airway. This case demonstrates the need for thorough preadministration physical examination, as well as careful monitoring during infusion and after administration of this potent therapeutic agent.
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