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Acta Otorhinolaryngologica Italica :... Dec 2022To evaluate outcomes of the surgical and rehabilitative procedures devoted to release the tongue-tie in non-infants when implementing the most commonly used... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate outcomes of the surgical and rehabilitative procedures devoted to release the tongue-tie in non-infants when implementing the most commonly used quantitative/qualitative structured tools for tongue and frenulum assessment.
METHODS
A scoping review and meta-analysis were conducted following the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews.
RESULTS
The systematic search retrieved 603 (Pubmed), 893 (Scopus), and 739 (ISI Web of Science) articles from January 2011 to December 2021. A total of 50 articles were retrieved for full-text review of which 7 were selected and included based on inclusion criteria. The majority of treatment options have been found to significantly improve the anatomical limitation of the tongue with clear benefits on descending functionality.
CONCLUSIONS
The review highlights an overall improvement in terms of clinical and functional outcomes when using validated tongue assessment tools both before and after frenulum release. This highlights the need for their rigorous implementation in research and clinical practice.
Topics: Female; Humans; Lingual Frenum; Breast Feeding; Ankyloglossia; Tongue
PubMed: 36654515
DOI: 10.14639/0392-100X-N2211 -
Medicina (Kaunas, Lithuania) Aug 2021: Ankyloglossia is a functional term describing limitations of motor activity of the tongue due to the embryological malformation of the lingual frenulum. The lingual...
: Ankyloglossia is a functional term describing limitations of motor activity of the tongue due to the embryological malformation of the lingual frenulum. The lingual frenulum has a complex, three-dimensional structure, it is not only a mucosal fold, which connects the ventral surface of the tongue and the floor of the mouth. Such knowledge forced us to develop more advanced techniques for tongue release in ankyloglossia. The aim of this study is to describe a novel, precise surgical technique for tongue release. : Miofrenuloplasty was performed in six patients with impaired tongue movements due to anatomical limitations. All of them were prepared for surgery and evaluated after the procedure by a speech therapist. The healing process was uneventful in all patients. We did not observe any major complications. Tongue mobility and neck muscle tension improved significantly in all cases. In one case, the speech improvement was minor. : Miofrenuloplasty is an advanced, but effective and highly predictable procedure for full functional tongue release in cases caused by MFGG complex. It should be done by experienced surgeon.
Topics: Adolescent; Adult; Ankyloglossia; Breast Feeding; Female; Humans; Lingual Frenum; Tongue
PubMed: 34441053
DOI: 10.3390/medicina57080848 -
Seizure Dec 2020There is a harmful myth that persists in modern culture that one should place objects into a seizing person's mouth to prevent "swallowing the tongue." Despite expert... (Review)
Review
OBJECTIVE
There is a harmful myth that persists in modern culture that one should place objects into a seizing person's mouth to prevent "swallowing the tongue." Despite expert guidelines against this, the idea remains alive in popular media and public belief. We aimed to investigate the myth's origins and discredit it.
METHODS
A medical and popular literature review was conducted for the allusions to "swallowing one's tongue" and practice recommendations for and against placing objects into a seizing person's mouth. Current prevalence of these beliefs and relevant anatomy and physiology were summarised.
RESULTS
The first English language allusions to placing objects in a patient's mouth occurred in the mid-19th century, and the first allusions to swallowing one's tongue during a seizure occurred in the late 19th century. By the mid-20th century, it was clear that some were recommending against the practice of placing objects in a patient's mouth to prevent harm. Relatively recent popular literature and film continue to portray incorrect seizure first aid through at least 2013. There is ample modern literature confirming the anatomical impossibility of swallowing one's tongue and confirming the potential harm of putting objects in a patient's mouth.
CONCLUSION
One cannot swallow their tongue during a seizure. Foreign objects should not be placed into a seizing person's mouth. We must continue to disseminate these ideas to our patients and colleagues. As neurologists, we have an obligation to champion safe practices for our patients, especially when popular media and culture continue to propagate dangerous ones.
Topics: Deglutition; First Aid; Humans; Mouth; Public Health; Seizures; Tongue
PubMed: 33080482
DOI: 10.1016/j.seizure.2020.09.023 -
World Journal of Gastroenterology Aug 2014Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the... (Review)
Review
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.
Topics: Diagnosis, Differential; Humans; Predictive Value of Tests; Risk Factors; Tongue; Tongue, Hairy; Treatment Outcome
PubMed: 25152586
DOI: 10.3748/wjg.v20.i31.10845 -
Annual Review of Physiology Feb 2017The tongue is an elaborate complex of heterogeneous tissues with taste organs of diverse embryonic origins. The lingual taste organs are papillae, composed of an... (Review)
Review
The tongue is an elaborate complex of heterogeneous tissues with taste organs of diverse embryonic origins. The lingual taste organs are papillae, composed of an epithelium that includes specialized taste buds, the basal lamina, and a lamina propria core with matrix molecules, fibroblasts, nerves, and vessels. Because taste organs are dynamic in cell biology and sensory function, homeostasis requires tight regulation in specific compartments or niches. Recently, the Hedgehog (Hh) pathway has emerged as an essential regulator that maintains lingual taste papillae, taste bud and progenitor cell proliferation and differentiation, and neurophysiological function. Activating or suppressing Hh signaling, with genetic models or pharmacological agents used in cancer treatments, disrupts taste papilla and taste bud integrity and can eliminate responses from taste nerves to chemical stimuli but not to touch or temperature. Understanding Hh regulation of taste organ homeostasis contributes knowledge about the basic biology underlying taste disruptions in patients treated with Hh pathway inhibitors.
Topics: Animals; Hedgehog Proteins; Homeostasis; Humans; Signal Transduction; Taste; Tongue
PubMed: 28192057
DOI: 10.1146/annurev-physiol-022516-034202 -
NeuroImage. Clinical 2020A few systematic imaging studies employing ultrasound (HRUS) and magnetic resonance imaging (MRI) have suggested tongue measures to aid in diagnosis of amyotrophic...
A few systematic imaging studies employing ultrasound (HRUS) and magnetic resonance imaging (MRI) have suggested tongue measures to aid in diagnosis of amyotrophic lateral sclerosis (ALS). The relationship between structural tongue alterations and the ALS patients' bulbar and overall motor function has not yet been elucidated. We here thus aimed to understand how in-vivo tongue alterations relate to motor function and motor function evolution over time in ALS. Our study included 206 ALS patients and 104 age- and sex-matched controls that underwent HRUS and 3T MRI of the tongue at baseline. Sonographic measures comprised coronal tongue echointensity, area, height, width and height/width ratio, while MRI measures comprised sagittal T1 intensity, tongue area, position and shape. Imaging-derived markers were related to baseline and longitudinal bulbar and overall motor function. Baseline T1 intensity was lower in ALS patients with more severe bulbar involvement at baseline. Smaller baseline coronal (HRUS) and sagittal (MRI) tongue area, smaller coronal height (HRUS) and width (HRUS) as well as more rounded sagittal tongue shape predicated more rapid functional impairment - not only of bulbar, but also of overall motor function - in ALS. Our results suggest that in-vivo sonography und MRI tongue measures could aid as biomarkers to reflect bulbar and motor function impairment.
Topics: Aged; Amyotrophic Lateral Sclerosis; Cross-Sectional Studies; Female; Humans; Longitudinal Studies; Magnetic Resonance Imaging; Male; Middle Aged; Tongue; Ultrasonography
PubMed: 32171167
DOI: 10.1016/j.nicl.2020.102233 -
Biology Letters Dec 2021Three-dimensional (3D) tongue movements are central to performance of feeding functions by mammals and other tetrapods, but 3D tongue kinematics during feeding are...
Three-dimensional (3D) tongue movements are central to performance of feeding functions by mammals and other tetrapods, but 3D tongue kinematics during feeding are poorly understood. Tongue kinematics were recorded during grape chewing by macaque primates using biplanar videoradiography. Complex shape changes in the tongue during chewing are dominated by a combination of flexion in the tongue's sagittal planes and roll about its long axis. As hypothesized for humans, in macaques during tongue retraction, the middle (molar region) of the tongue rolls to the chewing (working) side simultaneous with sagittal flexion, while the tongue tip flexes to the other (balancing) side. Twisting and flexion reach their maxima early in the fast close phase of chewing cycles, positioning the food bolus between the approaching teeth prior to the power stroke. Although 3D tongue kinematics undoubtedly vary with food type, the mechanical role of this movement-placing the food bolus on the post-canine teeth for breakdown-is likely to be a powerful constraint on tongue kinematics during this phase of the chewing cycle. The muscular drivers of these movements are likely to include a combination of intrinsic and extrinsic tongue muscles.
Topics: Animals; Biomechanical Phenomena; Macaca; Mastication; Movement; Primates; Tongue
PubMed: 34905722
DOI: 10.1098/rsbl.2021.0431 -
Neuroradiology Oct 2023CT and MRI findings of tongue ptosis and atrophy should alert radiologists to potential pathology along the course of the hypoglossal nerve (cranial nerve XII), a purely... (Review)
Review
CT and MRI findings of tongue ptosis and atrophy should alert radiologists to potential pathology along the course of the hypoglossal nerve (cranial nerve XII), a purely motor cranial nerve which supplies the intrinsic and extrinsic muscles of the tongue. While relatively specific for hypoglossal nerve pathology, these findings do not accurately localize the site or cause of denervation. A detailed understanding of the anatomic extent of the nerve, which crosses multiple anatomic spaces, is essential to identify possible underlying pathology, which ranges from benign postoperative changes to life-threatening medical emergencies. This review will describe key imaging findings of tongue denervation, segmental anatomy of the hypoglossal nerve, imaging optimization, and comprehensive imaging examples of diverse pathology which may affect the hypoglossal nerve. Armed with this knowledge, radiologists will increase their sensitivity for detection of pathology and provide clinically relevant differential diagnoses when faced with findings of tongue ptosis and denervation.
Topics: Humans; Hypoglossal Nerve; Tongue; Magnetic Resonance Imaging
PubMed: 37540288
DOI: 10.1007/s00234-023-03204-y -
Journal of Oral Science 2017The tongue can move freely and is important in oral motor functions. Tongue movement must be coordinated with movement of the hyoid, mandible, and pharyngeal wall, to... (Review)
Review
The tongue can move freely and is important in oral motor functions. Tongue movement must be coordinated with movement of the hyoid, mandible, and pharyngeal wall, to which it is attached. Our previous study using isolated brainstem-spinal cord preparations showed that application of N-methyl-D-aspartate induces rhythmic activity in the hypoglossal nerve that is coincident with rhythmic activity in the ipsilateral trigeminal motor nerve. Partial or complete midline transection of the preparation only abolishes activity in the trigeminal motor nerve; therefore, the neuronal network contributing to coordinated activity of the jaw/tongue muscles is located on both sides of the preparation and sends motor commands to contralateral trigeminal motoneurons. Arterially perfused decerebrate rat preparations exhibit stable inspiratory activity in the phrenic nerve, with efferent nerves innervating the upper airway muscles (the hypoglossal nerve, a branch of the cervical spinal nerve, the external branch of the superior laryngeal nerve, and the recurrent laryngeal nerve) under normocapnic conditions (5% CO). During hypercapnia (8% CO), pre-inspiratory discharges appear in all nerves innervating upper airway muscles. Such coordinated activity in the pre-inspiratory phase contributes to dilation of the upper airway and improves hypercapnia.
Topics: Animals; Hypoglossal Nerve; Rats; Respiration; Sucking Behavior; Tongue
PubMed: 28637976
DOI: 10.2334/josnusd.16-0850 -
Muscle & Nerve Mar 2021We recently developed an inducible model of dysphagia using intralingual injection of cholera toxin B conjugated to saporin (CTB-SAP) to cause death of hypoglossal...
INTRODUCTION
We recently developed an inducible model of dysphagia using intralingual injection of cholera toxin B conjugated to saporin (CTB-SAP) to cause death of hypoglossal neurons. In this study we aimed to evaluate tongue morphology and ultrastructural changes in hypoglossal neurons and nerve fibers in this model.
METHODS
Tissues were collected from 20 rats (10 control and 10 CTB-SAP animals) on day 9 post-injection. Tongues were weighed, measured, and analyzed for microscopic changes using laminin immunohistochemistry. Hypoglossal neurons and axons were examined using transmission electron microscopy.
RESULTS
The cross-sectional area of myofibers in the posterior genioglossus was decreased in CTB-SAP-injected rats. Degenerative changes were observed in both the cell bodies and distal axons of hypoglossal neurons.
DISCUSSION
Preliminary results indicate this model may have translational application to a variety of neurodegenerative diseases resulting in tongue dysfunction and associated dysphagia.
Topics: Animals; Axons; Cholera Toxin; Deglutition Disorders; Disease Models, Animal; Hypoglossal Nerve; Immunohistochemistry; Injections, Intramuscular; Laminin; Motor Neurons; Muscle Fibers, Skeletal; Neurons; Organ Size; Rats; Saporins; Tongue
PubMed: 33269488
DOI: 10.1002/mus.27131