Isolated congenital bifid tongue

Case report: Hereditary sensory autonomic neuropathy presenting as bifid deformity to the tongue

Hereditary sensory autonomic neuropathy (HSAN) is a group of rare genetic disorders in which affected patients have a diminished capacity to feel pain. Patients with HSAN may present with a wide range of factitial injuries, where injury to the oral cavity may be an early presenting sign. While existing literature on HSAN is scant, many reports highlight the long-term outcomes that may include enucleation of eyes, amputation of fingers and limbs, and disfigurement of the tongue. This case describes a five-month-old female with repetitive injury to the tongue causing it to heal with a bifid deformity. The patient was later diagnosed with HSAN type 4. This case highlights the importance of recognition of extensive oral trauma as one of the early signs of HSAN that should provoke a timely referral for neurological assessment.

Familial cleft tongue caused by a unique translation initiation codon variant in TP63

Variants in transcription factor p63 have been linked to several autosomal dominantly inherited malformation syndromes. These disorders show overlapping phenotypic characteristics with various combinations of the following features: ectodermal dysplasia, split-hand/foot malformation/syndactyly, lacrimal duct obstruction, hypoplastic breasts and/or nipples, ankyloblepharon filiforme adnatum, hypospadias and cleft lip/palate. We describe a family with six individuals presenting with a striking novel phenotype characterized by a furrowed or cleft tongue, a narrow face, reddish hair, freckles and various foot deformities. Whole-exome sequencing (WES) identified a novel heterozygous variant, c.3G>T, in TP63 affecting the translation initiation codon (p.1Met?). Sanger sequencing confirmed dominant inheritance of this unique variant in all six affected family members. In summary, our findings indicate that heterozygous variants in TP63 affecting the first translation initiation codon result in a novel phenotype dominated by a cleft tongue, expanding the complex genotypic and phenotypic spectrum of TP63-associated disorders.

Traumatic bifid tongue: A rare presentation in a child. Case report

Introduction

Although most tongue lacerations in children can be treated conservatively, accepted indications for suture repair include complex injury, large flaps, and active bleeding. The purpose of this article is to highlight repair of a unique, severe injury pattern in a child.

Presentation and treatment

A 3-year-old boy fell on a cemented floor causing a midline full-thickness laceration through the median fibrous septum, resulting in a bifid tongue. Given the midline location, neurovascular supply was protected, and following surgical repair, the patient enjoyed an uneventful recovery.

Conclusion

Our case outlines a surgical approach for this unique case of acquired traumatic pediatric bifid tongue, which to our knowledge, has never been reported in the English literature.

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This presented case highlights a unique severe injury pattern in a child.

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A 3-year-old presented with a unique acquired traumatic bifid tongue injury.

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He underwent successful functional and aesthetic surgical repair.

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To the best of our knowledge, this rare presentation of traumatic bifid tongue in a child has not been reported in the English literature.

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The case has been presented based on SCARE guidelines.

Salivary hamartoma with a bifid tongue in an adult patient

Congenital anomalies of tongue are rare disorders usually associated with syndromes. In present article we describe a case of a non-syndromic adult patient with bifid tongue with salivary hamartoma on the dorsum of the tongue. We described the clinical features, problems faced by the patient and management. As etiology is uncertain we should have proper understanding of embryology.

How to make a tongue: Cellular and molecular regulation of muscle and connective tissue formation during mammalian tongue development

The vertebrate tongue is a complex muscular organ situated in the oral cavity and involved in multiple functions including mastication, taste sensation, articulation and the maintenance of oral health. Although the gross embryological contributions to tongue formation have been known for many years, it is only relatively recently that the molecular pathways regulating these processes have begun to be discovered. In particular, there is now evidence that the Hedgehog, TGF-Beta, Wnt and Notch signaling pathways all play an important role in mediating appropriate signaling interactions between the epithelial, cranial neural crest and mesodermal cell populations that are required to form the tongue. In humans, a number of congenital abnormalities that affect gross morphology of the tongue have also been described, occurring in isolation or as part of a developmental syndrome, which can greatly impact on the health and well-being of affected individuals. These anomalies can range from an absence of tongue formation (aglossia) through to diminutive (microglossia), enlarged (macroglossia) or bifid tongue. Here, we present an overview of the gross anatomy and embryology of mammalian tongue development, focusing on the molecular processes underlying formation of the musculature and connective tissues within this organ. We also survey the clinical presentation of tongue anomalies seen in human populations, whilst considering their developmental and genetic etiology.