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Coexisting congenital sublingual dermoid and bronchogenic cyst.

A congenital dermoid together with a bronchogenic cyst at the base of the tongue is extremely rare. We describe a 5-year-old boy who presented with an enlarged anterior segment of mandible, slight swelling of the left submandibular region, and a large swelling of the floor of the mouth that was displacing the tongue posteriorly. Both cysts were successfully excised and the boy made an uncomplicated recovery. Occlusion and mastication returned to normal and his speech improved remarkably.

Bronchogenic Cyst↗

[Ultrasonic diagnosis of the tongue].

Ultrasonic diagnosis of the tongue supplements inspection and palpation, and, aside from computerized tomography and, in particular, nuclear spin tomography, broadens our knowledge. By way of introduction, transcutaneous treatment using the submental sound-scanner in "B" mode is described. If necessary, examination can be performed simultaneously in the "B" and "M" modes. Attention is drawn to the significance of the 5 cm distance between the floor of the mouth and the surface of the tongue. Indications range from the diagnosis of tongue carcinoma, including relapse diagnosis, to dynamic functional tests of neurological disorders and visual biofeedback in phoniatrics and logopedics. Median-line diagnosis is of critical importance in tongue carcinoma. Ultrasonic diagnosis of the tongue can be recommended as a simple and cost-saving routine method.

Deglutition↗

Benign lingual lesions of intrinsic origin. Differential diagnosis.

The tongue is the site of origin of a variety of reactive, neoplastic, and developmental swellings that all share a benign pattern of growth. They are significant because they can interfere with function, they can be mistaken for malignancy, or they can represent part of a syndrome. Distinctive clinicopathologic features of each are useful in differential diagnosis.

Condylomata Acuminata↗

Glioma of the tongue.

A case of glioma of the tongue that was treated successfully by simple excision and repair is presented. It may represent neural tissue that remains in the occipital somites that differentiate into the tongue muscles. Histologically, it consists of sheets of glial tissue. The literature is reviewed, and the case is discussed.

Child, Preschool↗

Evaluation of intubation using the Airtraq or Macintosh laryngoscope by anaesthetists in easy and simulated difficult laryngoscopy--a manikin study.

The Airtraq Laryngoscope is a novel intubation device which allows visualisation of the vocal cords without alignment of the oral, pharyngeal and tracheal axes. We compared the Airtraq with the Macintosh laryngoscope in simulated easy and difficult laryngoscopy. Twenty-five anaesthetists were allowed up to three attempts to intubate the trachea in each of three laryngoscopy scenarios using a Laerdal Intubation Trainer followed by five scenarios using a Laerdal SimMan Manikin. Each anaesthetist then performed tracheal intubation of the normal airway a second time to characterise the learning curve. In the simulated easy laryngoscopy scenarios, there was no difference between the Airtraq and the Macintosh in success of tracheal intubation. The time taken to intubate at the end of the protocol was significantly lower using the Airtraq (9.5 (6.7) vs. 14.2 (7.4) s), demonstrating a rapid acquisition of skills. In the simulated difficult laryngoscopy scenarios, the Airtraq was more successful in achieving tracheal intubation, required less time to intubate successfully, caused less dental trauma, and was considered by the anaesthetists to be easier to use.

Constriction, Pathologic↗

Dyskeratosis congenita in a female.

We report a 9-year-old Saudi girl with dyskeratosis congenita. In addition to the known manifestations of this disease, she also had the additional features of tufts of hairs on the limbs, and an early onset of keratinized basal cell papillomas on her trunk.

Child↗

Decreased tongue mobility -- an explanation for difficult endotracheal intubation?

Established parameters predictive of difficulty in airway management were inconclusive in five ear, nose and throat (ENT) patients. All presented with degrees of tongue fixation - restriction of movement. Initially, experienced anaesthetists concluded that conventional endotracheal intubation would present no problems. Later, there were adjustments to this conclusion, with the ultimate being that four of the patients underwent fibre-optic intubation: one electively, two after repeated failed conventional attempts and one after a failed attempt of retrograde intubation. The last patient underwent elective retrograde intubation. All intubations were performed uneventfully in anaesthetized or sedated patients under spontaneous respiration. We found that tongue fixation was a direct cause of failed conventional endotracheal intubation, and recommend that a detailed tongue status investigation should be routine during Mallampati evaluation. Any abnormality should be seen as predictive of difficult/impossible conventional direct laryngoscopic intubation.

Aged↗

Lingual subgemmal neurogenous plaques with pseudoepitheliomatous hyperplasia: incidental pseudomalignant condition.

Pseudoepitheliomatous hyperplasia is a reactive proliferation of benign squamous epithelium that can mimic squamous cell carcinoma. Herein is a report on this type of reaction on two subgemmal neurogenous plaques in a lingual circumvallate papilla. To the authors' knowledge this is the first report on this combination of lesions. A 66-year-old man died with disseminated squamous cell carcinoma of the lung. At autopsy the tongue was found to have an incidental pseudoepitheliomatous hyperplasia on two subgemmal neurogenous plaques with ganglion cells. Subgemmal neurogenous plaque should be included in the differential diagnosis of causes of lingual pseudoepitheliomatous hyperplasia. Awareness of the morphological spectrum of subgemmal neurogenous plaques can avoid the overdiagnosis of these lesions as neural tumors or squamous cell carcinoma.

Aged↗