Cisticercosis lingual. Diagnóstico, manejo clínico y tratamiento de un caso clínico / Lingual cysticercosis. Diagnosis, clinical management and treatment of a clinical case

Objetivo: Las comunicaciones bucosinusales y buco- nasales son condiciones patológicas que se caracterizan por la presencia de una solución de continuidad entre la cavidad bucal y el seno maxilar o la cavidad nasal respectivamente. Una vez que se ha instalado una comunicación es deseable ce- rrar este defecto, evitando así la infección del seno maxilar y posibles dificultades en la deglución, fonación y masticación. Se han propuesto diferentes tratamientos para su resolución, algunos no quirúrgicos y otros quirúrgicos. Los quirúrgicos pueden realizarse desplazando tejidos locales, regionales o injertando. El presente trabajo tiene como objetivo presentar situaciones clínicas de comunicaciones bucosinusales y buco- nasales con diferentes etiologías y sus distintos tratamientos según tamaño y ubicación del defecto. Casos clínicos: Se identificaron pacientes que asistie- ron al Servicio de Cirugía Maxilofacial del Hospital Piñero presentando cuatro comunicaciones bucosinusales agudas y crónicas y una comunicación buconasal crónica. Los casos analizados fueron tratados de manera quirúrgica utilizando di- versos colgajos según tamaño y ubicación del defecto (AU)

Aim: Oroantral and oronasal communications are patho- logical conditions characterized by the presence of a solu- tion of continuity between the oral cavity and the maxillary sinus or nasal cavity respectively. Once a communication has been installed, it is desirable to close this defect, thus avoid- ing infection of the maxillary sinus and possible difficulties in swallowing, phonation, and mastication. Different treatments have been proposed for its resolution, some non-surgical and others surgical. Surgical procedures can be performed by dis- placing local or regional tissue or by grafting. The aim of this case report is to present clinical situations of oral sinus and oral nasal communication with different etiologies and their different treatments according to the size and location of the defect. Clinical cases: A group of patients who attended the Maxillofacial Surgery Service of Piñero Hospital presenting four acute and chronic oral sinus and one oronasal communi- cations were identified. The analyzed cases were treated sur- gically using different flaps according to the size and location of the defect (AU)

Malignant peripheral nerve sheath tumor of tongue: a case report / 华西口腔医学杂志

Malignant peripheral nerve sheath tumor (MPNST) is a rare neurogenic malignant tumor. MPNST has aty-pical clinical symptoms and imaging presentations, difficult diagnosis, a high degree of malignancy, and poor prognosis. It usually occurs in the trunk, approximately 20% in the head and neck, and rarely in the mouth. This paper reports a case of MPNST of the tongue. A summary of the clinical features, diagnosis, and treatment of MPNST is presented in combination with a literature review to provide a reference for the diagnosis and treatment of this disease.

Tongue Necrosis due to Giant Cell Arteritis / Necrose da língua por arterite de células gigantes

Giant Cell Arteritis is a vasculitis that mainly affects women over 50. The most common manifestations are headache, jaw claudication, and amaurosis. If not diagnosed early, it can lead to rare irreversible ischemic consequences, with tongue necrosis being one of these. We report a case of a previously undiagnosed patient with lateral tongue necrosis who responded well to oral corticosteroid treatment. The diagnosis is clinical, laboratory and histological and may be aided by imaging exams. Initial treatment is with oral corticosteroids, with methotrexate and tocilizumab as alternatives. Diagnostic suspicion and quick start of treatment favorably influence the prognosis of the disease (AU)

Apresentamos um caso de arterite de células gigantes com amaurose, seguida de necrose da língua, diagnosticado clinicamente com boa resposta terapêutica ao corticoide oral. Salientamos que os casos de necrose da língua são extremamente raros. A suspeita diagnóstica de arterite de células gigantes é de fundamental importância e mesmo na impossibilidade de realizar a biópsia de artéria temporal, não se deve retardar o início do tratamento sob pena de acarretar sequelas definitivas ou manifestações mais graves da doença (AU)

Oral manifestations of systemic fungal infections: 25-year experience in an endemic region

Some mycoses are endemic. They develop through hematogenous spread, causing a generalized infection, usually with secondary mucosal involvement.The aim of this observational and retrospective study was to report the prevalence and characteristics of oral lesions in patients diagnosed with systemic fungal infections (SFI) over a 25-year period in southern Brazil. Demographic (age, sex, ethnicity, occupation) and clinical (anatomical location, symptoms,histopathological diagnosis and management) data from the medical records of patients with SFI were collected from 1995 to 2019. 34 cases of SFI were found, of which 31 (91.18%) were diagnosed as paracoccidioidomycosis (PCM) and 3 (8.82%) as histoplasmosis. Men were much more affected (n = 31; 91.18%), with an average age of 46.9 years. Most patients (n = 18; 58.06%) were Caucasian; 48% (n = 15) were farm/rural workers and the most affected region was the jugal mucosa (n = 13; 25.49%) followed by the alveolar ridge (n = 12; 23.52%). All patients with histoplasmosis were immunocompetent men (mean age: 52.67 years), and the palate was the most affected. All patients underwent incisional biopsy and were referred to an infectologist. The dentist has an essential role in the recognition of SFI, whose oral manifestations may be the first sign. SFI should be included in differential diagnosis in patients from endemic areas. In addition, the inevitable human mobility and globalization make knowledge of these mycosesnecessary worldwide, especially since advanced cases in immunocompromised patients can be fatal.

Schwannoma lingual: presentación de un caso y breve revisión de la literatura / Lingual schwannoma: case report and brief review of the literature

Objetivo: Reportar un caso de schwannoma lingual, así como revisar las características diagnósticas (clínicas, por imágenes e histopatológicas) y terapéuticas de esta patología mediante las publicaciones disponibles. Caso clínico: Se presenta un caso de schwannoma in- traoral en un hombre de 26 años de edad con un tumor ubica- do en el tercio anterior de la lengua. Se resolvió mediante un único procedimiento quirúrgico bajo anestesia local sin obser- varse recidivas ni secuelas al menos a 12 meses de seguimien- to a distancia. El schwannoma de la lengua es poco frecuente pero sus características clínico-imagenológicas presentan ras- gos benignos que favorecen la resolución mediante una única biopsia quirúrgica total cuando el tamaño y la ubicación sean propicios para ello (AU)

To describe a case of lingual schwannoma, and through a literature review, to provide data on clinical, imaging and pathological features, as well as treatment methods. Clinical case: A 26-year-old male patient with a swelling in the tip of the tongue was diagnosed as having oral schwannoma. A single surgery was performed, without recurrence or postoperative complications at least during a 12-month follow-up. Lingual schwannoma is a rare entity with benign clinical and imaging characteristics that ena- ble surgical removal without prior biopsy when size and oral location are favorable (AU))

Fibroma de fibroblastos gigantes: presentación de 122 casos / Giant Cell fibroma: presentation of 122 cases

El fibroma de fibroblastos gigantes (FFG), conocido también como fibroma de células gigantes, es una pápula o nódulo asintomático localizado en la encía, paladar y lengua, es del mismo color que la mucosa adyacente, de base sésil o pediculada, con superficie lisa o papilar que por lo general mide menos de 1 cm. Objetivo: Identificar las características demográficas e histopatológicas de los casos de FFG de un laboratorio privado de patología bucal en la Ciudad de México. Material y métodos: Se obtuvieron los datos de edad, sexo, diagnóstico presuntivo y definitivo de 122 casos de FFG de 2004 a 2019 con un total de 7,681 muestras. Se describe su distribución por edad, sexo y localización. Resultados: El rango de edad obtenido es de 1 a 84 años, con un promedio de X = 38 años, se presenta con mayor frecuencia en la segunda década de vida, con una razón de 1.6:1 mujer a hombre. La localización más frecuente es en lengua (46%); sin embargo, sólo 49.1% de los estudios especificaban este dato. Conclusión: La importancia de esta lesión es que clínicamente se parece a otras patologías de tejido fibroso, por lo tanto, se debe tener presente al FFG como diagnóstico diferencial (AU)

Giant cell fibroma (GCF) is an asymptomatic papule or nodule that is similar in color to the surrounding mucosa, with a sessile or pedunculated base. It is usually less than 1 cm in size and it features a smooth or papillary surface. Objective: To identify the demographic and histopathological characteristics of GCF cases in a private oral pathology laboratory in Mexico City. Material and methods: Data on age, sex, as well as on presumptive and definitive diagnosis of 122 GCF cases were obtained from 2004 to 2019 with a total of 7,681 samples. Its distribution by age, sex and localization is described. Results: The age range obtained is from 1 to 84 years, with a mean age of 38 years. Frequently during the second decade of life, the female to male ratio is 1.6:1. The most frequent location is the tongue (46%), however, only 60 of 122 studies specified this data. Conclusion: Since this lesion clinically resembles another fibrous tissue pathology, it is warranted to have prior knowledge on its clinical characteristics, as GCF should be regarded as a differential diagnosis (AU)

Oral hairy polyp in a teenager: case report and literature review / Pólipo piloso oral em um adolescente: relato de caso e revisão de literatura

ABSTRACT Objective: To report an unusual case of oral hairy polyp (HP) and review the literature, providing epidemiological, clinical and histopathological information on this disease. Case description: A 12-year-old male patient was referred to a Stomatology department with a nodule in the posterior midline of the tongue. The patient did not know exactly when it arose or whether it had grown since then. Clinical exam revealed a bulky and mobile pedunculated mass lesion on the dorsum of the tongue, with a diameter of approximately 1 cm. The patient's mother reported no previous health problem. An excisional biopsy was performed, the surgical specimen was sent for anatomopathological analysis, and the findings were compatible with the diagnosis of HP. Comments: Hairy polyp is a rare lesion, especially in the oral region. The literature search revealed only 10 case reports of oral HP published between January 1999 and January 2019, and they revealed a predominance of the disease in female newborns. Two uncommon facts were presented in this case: the patient was male and diagnosis was made at 12 years old.

RESUMO Objetivo: Relatar um caso incomum de pólipo piloso (PP) oral e revisar a literatura para trazer informações epidemiológicas, clínicas e histopatológicas acerca da doença. Descrição do caso: Paciente do sexo masculino, 12 anos de idade, encaminhado ao Departamento de Estomatologia com nódulo na região posterior de linha média da língua. O paciente não soube relatar quando surgiu a lesão e se ela havia crescido desde então. O exame clínico revelou massa pedunculada, volumosa e móvel no dorso da língua, medindo aproximadamente 1,0 cm de diâmetro. A mãe do paciente relatou que ele nunca havia tido nenhum problema de saúde anterior. Foi realizada biópsia excisional e o material foi enviado para análise anatomopatológica, sendo os achados compatíveis com o diagnóstico de PP. Comentários: O pólipo piloso é uma lesão rara, especialmente na região oral. A pesquisa bibliográfica revelou apenas dez relatos de casos de PP oral, publicados entre janeiro de 1999 e janeiro de 2019, sendo observada predominância da doença em recém-nascidos do sexo feminino. Dois fatos incomuns ocorreram neste caso: tratava-se de um paciente do sexo masculino e o diagnóstico se deu aos 12 anos de idade.

Geographic stomatitis with palate involvement

Abstract: Benign migratory glossitis or geographic tongue is a benign condition that usually manifests as asymptomatic erythematous and migratory circinate patches, involving the lateral and dorsal aspects of the tongue. Extra-lingual lesions uncommonly occur and are mainly located on labial and buccal mucosae, lips and floor of the mouth. The present report describes one patient with a geographic lesion on the hard palate associated with lingual lesions and another patient who had multiple geographic lesions both in the hard and soft palate without lingual lesions. We found 64 cases in the English literature of ectopic locations with 22 palate involvement. No case of simultaneous involvement of the hard and the soft palate was found.

State-dependent changes in the upper airway assessed by multidetector CT in healthy individuals and during obstructive events in patients with sleep apnea / Alterações nas vias aéreas superiores avaliadas por TC multidetectores durante a vigília e o sono em indivíduos saudáveis e em pacientes com apneia do sono durante eventos obstrutivos

ABSTRACT Objective: To determine whether airway narrowing during obstructive events occurs predominantly at the retropalatal level and results from dynamic changes in the lateral pharyngeal walls and in tongue position. Methods: We evaluated 11 patients with severe obstructive sleep apnea (OSA) and 7 healthy controls without OSA during wakefulness and during natural sleep (documented by full polysomnography). Using fast multidetector CT, we obtained images of the upper airway in the waking and sleep states. Results: Upper airway narrowing during sleep was significantly greater at the retropalatal level than at the retroglossal level in the OSA group (p < 0.001) and in the control group (p < 0.05). The retropalatal airway volume was smaller in the OSA group than in the control group during wakefulness (p < 0.05) and decreased significantly from wakefulness to sleep only among the OSA group subjects. Retropalatal pharyngeal narrowing was attributed to reductions in the anteroposterior diameter (p = 0.001) and lateral diameter (p = 0.006), which correlated with an increase in lateral pharyngeal wall volume (p = 0.001) and posterior displacement of the tongue (p = 0.001), respectively. Retroglossal pharyngeal narrowing during sleep did not occur in the OSA group subjects. Conclusions: In patients with OSA, upper airway narrowing during sleep occurs predominantly at the retropalatal level, affecting the anteroposterior and lateral dimensions, being associated with lateral pharyngeal wall enlargement and posterior tongue displacement.

Resumo Objetivo: Determinar se o estreitamento das vias aéreas durante eventos obstrutivos ocorre predominantemente na região retropalatal e resulta de alterações dinâmicas nas paredes laterais da faringe e na posição da língua. Métodos: Avaliamos 11 pacientes com apneia obstrutiva do sono (AOS) grave (grupo AOS) e 7 indivíduos saudáveis sem AOS (grupo controle) durante a vigília e o sono natural (documentado por meio de polissonografia completa). Por meio de TC multidetectores rápida, obtivemos imagens das vias aéreas superiores no estado de vigília e de sono. Resultados: O estreitamento das vias aéreas superiores durante o sono foi significativamente maior na região retropalatal do que na região retrolingual no grupo AOS (p < 0,001) e no grupo controle (p < 0,05). O volume da via aérea retropalatal foi menor no grupo AOS do que no grupo controle durante a vigília (p < 0,05) e diminuiu significativamente da vigília ao sono apenas no grupo AOS. O estreitamento retropalatal da faringe foi atribuído à redução do diâmetro anteroposterior (p = 0,001) e lateral (p = 0,006), que se correlacionou com o aumento do volume das paredes laterais da faringe (p = 0,001) e o deslocamento posterior da língua (p = 0,001). Não ocorreu estreitamento retrolingual da faringe durante o sono no grupo AOS. Conclusões: Em pacientes com AOS, o estreitamento das vias aéreas superiores durante o sono ocorre predominantemente na região retropalatal e afeta as dimensões anteroposterior e lateral, além de estar relacionado com aumento das paredes laterais da faringe e deslocamento posterior da língua.

Relação entre a etiologia da respiração oral e a pressão máxima da língua / Relationship between mouth breathing etiology and maximum tongue pressure

RESUMO Objetivo Verificar a existência de relação entre pressão máxima da língua e a etiologia da respiração oral em crianças respiradoras orais atendidas em um Ambulatório do Respirador Oral. Método Foi conduzido um estudo transversal observacional descritivo e analítico com 59 crianças respiradoras orais com idades entre três e 12 anos (média de 6,5 anos e DP=2,4). Para a coleta da pressão de língua, foi utilizado o Iowa Oral Performance Instrument - (IOPI) e dados sobre a etiologia da respiração oral e oclusão dentária foram coletados nos prontuários desses pacientes para análise. As associações entre a pressão máxima da língua e a etiologia da respiração oral, idade, gênero e oclusão dentária foram verificadas pelo teste T, ANOVA, coeficiente de Spearman e Teste de Tuckey, utilizando-se nível de significância de 5%. Resultados Houve correlação moderada e positiva entre idade e pressão máxima, verificou-se que houve diferença estatisticamente significativa entre a pressão máxima da língua e as variáveis hipertrofia da tonsila faríngea e hipertrofia das tonsilas palatinas. Não foram verificadas diferenças estatísticas entre as outras variáveis. Conclusão Conclui-se que as obstruções mecânicas, dentre elas a hipertrofia das tonsilas faríngea e palatinas alteram a pressão máxima de língua em crianças respiradoras orais.

ABSTRACT Purpose To verify the relationship between maximum tongue pressure and the etiology of oral breathing in oral breathing children attended at the Oral Respiratory Outpatient Clinic. Methods A descriptive and analytical cross-sectional study was accomplished with 59 mouth breathing children aged 3 to 12 years (mean age 6.5 years and SD: standard deviation= 2.4). To collect tongue pressure, the Iowa Oral Performance Instrument (IOPI) was used and data regarding the etiology of oral breathing and dental occlusion were collected in the records of these patients for analysis. The associations between the maximum tongue pressure and the etiology of oral breathing, age, gender and dental occlusion were verified by the T test, ANOVA, Spearman's coefficient and Tuckey's test, using a significance level of 5%. Results There was a moderate and positive correlation between age and maximum pressure, it was verified that there was a statistically significant difference between the maximum tongue pressure and the variables pharyngeal tonsil hypertrophy and palatine tonsil hypertrophy. There were no statistical differences between the other variables. Conclusion It was concluded that mechanical obstructions, among them the pharyngeal and palatine tonsil hypertrophy alter the maximum tongue pressure in oral breathing children.

Estomatitis Urémica como Complicación Oral de Insuficiencia Renal Crónica: Reporte de Caso y Revisión de la Literatura / Uremic Stomatitis as an Oral Complication of Chronic Renal Failure: Case Report and Literature Review

RESUMEN: La Estomatitis Urémica es una lesión oral poco frecuente que se presenta generalmente en pacientes con insuficiencia renal crónica avanzada o no tratada. A continuación, se reporta un caso clínico de un paciente masculino de 22 años de edad que acude a un servicio de urgencia con la presencia de placas blanquecinas indoloras en piso de boca, cara interna de mejilla, y lengua. Las probables causas, presentaciones clínicas, y manejo odontológico son discutidos.

ABSTRACT: Uremic stomatitis is a rare oral lesion that usually occurs in patients with advanced or untreated chronic renal failure. Here we report a case of a 22-year-old male patient who comes to an emergency department with the presence of painless whitish plaques on the floor of the mouth, internal cheek face, and tongue. Probable causes, clinical presentations, and dental management are discussed.

Evaluation of tongue/mandible volume ratio in children with obstructive sleep apnea

ABSTRACT Objective: The present study was an attempt to investigate tongue/mandible volume ratio in children, using volumetric magnetic resonance imaging (MRI) for early screening and to aid in treatment planning. Methods: Volumetric evaluation of tongue volume/mandible volume ratio (TV/MV ratio) in children with obstructive sleep apnea (OSA) using MRI was carried out retrospectively on available DICOM MR images of children in the age group of 10-14 years. MRI image records of patients diagnosed with OSA were obtained from interventional radiology department records, at Sharad Pawar Dental College and Hospital (Datta Meghe Institute of Medical Sciences, Nagpur/India). The age, gender, height and weight of the subjects were retrieved from patient database and registered. For the control group, available MRI images of healthy subjects without OSA were retrieved. Body mass index (BMI) was also calculated using the height and the weight present in the records. Measurements from MR images were made using DICOM image processing software. Soft tissue and bony structure segmentation was performed by manual tracing. The tongue volume and mandible volume were directly computed using the software. The tongue volume/mandible volume ratio (TV/MV) was generated using the above values and expressed as a percentage for both groups. Results: The difference between OSA group and control group with respect to TV/MV ratio was found to be highly significant at 0.05 level of significance. There was no significant correlation between BMI and TV/MV ratio in OSA group (p= 0.451) as well as in control group (p= 0.094). Conclusion: TV/MV ratio may be an appropriate variable to evaluate the risk of OSA, representing the balance between skeletal morphology and soft tissue morphology in craniofacial complex.

Resumo Objetivo: o presente estudo foi uma tentativa de investigar a relação volumétrica língua/mandíbula em crianças, usando imagens de ressonância magnética (IRM), para triagem inicial e como meio auxiliar no plano de tratamento. Métodos: a avaliação da relação volume da língua/volume da mandíbula (relação VL/VM) em crianças com apneia obstrutiva do sono (AOS) utilizando IRM foi realizada retrospectivamente em imagens de RM em formato DICOM disponíveis de crianças na faixa etária de 10 a 14 anos. As documentações com IRM de pacientes com diagnóstico de AOS foram obtidas nos arquivos do departamento de radiologia da Sharad Pawar Dental College and Hospital (Datta Meghe Institute of Medical Sciences, Nagpur/Índia). A idade, o sexo, altura e peso dos indivíduos foram obtidos a partir dos registros dos pacientes. Para o grupo controle, foram selecionadas imagens de RM disponíveis de indivíduos saudáveis sem AOS. O índice de massa corporal (IMC) também foi calculado a partir da altura e do peso constantes nos registros. As medições nas imagens de RM foram feitas usando um software de processamento de imagens DICOM. A segmentação entre tecidos moles e estrutura óssea foi realizada por delineamento manual. O volume da língua e o volume da mandíbula foram calculados diretamente com o software. A relação volume da língua/volume da mandíbula (VL/VM) foi calculada usando os valores acima e expressa em porcentagens, para ambos os grupos. Resultados: a diferença entre o grupo com AOS e o grupo controle, quanto à relação VL/VM, foi altamente significativa ao nível de significância de 0,05. Não houve, porém, correlação significativa entre o IMC e a relação VL/VM, nem no grupo AOS (p= 0,451), nem no grupo controle (p= 0,094). Conclusão: a relação VL/VM pode ser uma variável apropriada para se avaliar o risco de AOS, representando o equilíbrio entre a morfologia esquelética e a morfologia dos tecidos moles no complexo craniofacial.

Oral mucosa lesions as atypical manifestation of adult-onset Still´s disease

Abstract: Adult-onset Still's disease is a systemic inflammatory disorder of unknown etiology, characterized by skin rash, spiking fever, arthralgias or arthritis, and leukocytosis. The typical skin rash is evanescent, salmon-pink, nonpruritic and maculopapular, predominantly on the extremities. It is considered one of the major Yamaguchi's criteria in adult-onset Still's disease. However, atypical skin lesions are also described. Here, a 61-year-old woman with sore throat, spiking fever, polyarthritis and evanescent salmon-pink nonpruritic maculopapular skin rash on the extremities was diagnosed with adult-onset Still's disease. In addition, atypical brown macules on oral mucosa, localized on the inner lips and tongue were also observed. Biopsy revealed a neutrophilic infiltrate. Despite treatment and improvement of the adult-onset Still's disease, the atypical oral mucosal lesions persisted.

Alteration of taste buds in experimental cirrhosis. Is there correlation with human hypogeusia? / Alteração de paladar em um modelo experimental de cirrose. Existe correlação com hipogeusia humana?

ABSTRACT Background The inherent complications of cirrhosis include protein-calorie malnutrition and micronutrient deficiencies.Changes in taste are detrimental to the nutritional status, and the mechanism to explain these changes is not well documented in the cirrhotic patients. Objective To evaluate the taste buds of cirrhotic rats. Methods Fourteen male Wistar rats were evaluated. After 16 weeks, the liver was removed to histologically diagnose cirrhosis, and blood was collected to perform liver integrity tests. The tongue was removed for histological examination and immunohistochemistry using antibodies against protein gene product PGP 9.5 and the sweet taste receptors T1R2 and T1R3. Morphological changes were determined by scanning electron microscopy. Serum zinc levels were measured. Results The cirrhotic animals, but not the control animals, exhibited zinc deficiency. In both groups, there was positive immunoreactivity for type II and III cells and T1R2 receptors. The cirrhotic animals had no immunoreactivity for T1R3 receptors. Scanning electron microscopy analysis of the cirrhotic group revealed a uniform tapering of the gustatory papillae. Conclusion In conclusion the experimental cirrhosis model mimicked the biochemical and histological parameters of human cirrhosis, therefore enabling a study of the gustatory papillae and taste buds.

RESUMO Contexto As complicações inerentes de cirrose incluem a desnutrição proteico-calórica e deficiências de micronutrientes. Alterações no paladar são prejudiciais para o estado nutricional e o mecanismo para explicar essas mudanças não é bem documentada nos pacientes cirróticos. Objetivo Avaliar as papilas gustativas de ratos cirróticos. Métodos Foram avaliados 14 ratos Wistar machos. Após 16 semanas, o fígado foi removido para diagnosticar histologicamente cirrose, e o sangue foi colhido para efetuar testes de integridade hepática. A língua foi removida para exame histológico e imuno-histoquímica utilizando anticorpos contra o gene da proteína PGP 9.5 e os receptores de sabor doce T1R2 e T1R3. As alterações morfológicas foram determinadas por microscopia eletrônica de varredura e os níveis de zinco no soro foram medidos. Resultados Os animais cirróticos, em relação aos animais controle, apresentaram deficiência de zinco significativa. Em ambos os grupos, houve imunorreatividade positiva para o tipo II e células III e receptores T1R2. Os animais cirróticos não tinham imunoreactividade para receptores T1R3. Microscopia eletrônica de varredura do grupo cirrótico revelou um afilamento uniforme das papilas gustativas. Conclusão O modelo de cirrose experimental imitou os parâmetros bioquímicos e histológicos de cirrose humana, portanto, permitindo um estudo das papilas gustativas e paladar.

The effect of hippophae rhamnoides extract on oral mucositis induced in rats with methotrexate

ABSTRACT Objective: To investigate the effect of HRE (Hippophae rhamnoides extract) on oral mucositis induced in rats with MTX. Material and Methods: Experimental animals were divided into groups as healthy (HG), HRE+MTX (HMTX), and control group, which received MTX (MTXC). HMTX group received 50 mg/kg HRE while MTXC and HG groups received equivolume distilled water with gavage once a day. After one hour of HRE and distilled water administration, HMTX and MTXC groups received a single dose of oral MTX 5 mg/ kg. This procedure was repeated for one month. Results: The levels of MDA, IL-1β, and TNF-α were found to be significantly higher in the cheek, lower lip, and tongue tissue of the animals receiving MTX, compared with HG and HMTX groups; however, these parameters were lower in the cheek and low lip tissue, and a milder damage ocurred in these tissues, compared with the tongue tissue in MTXC group. No histopathologic damage was observed in the cheek, lower lip, and tongue tissues of the rats treated with HRE. Conclusion: This findings indicate that HRE as a natural product is an important advantage compared with synthetic drugs for prophylaxis of oral mucositis developed due to MTX.

Analysis of speech and tongue motion in normal and post-glossectomy speaker using cine MRI

ABSTRACT Objective Since the tongue is the oral structure responsible for mastication, pronunciation, and swallowing functions, patients who undergo glossectomy can be affected in various aspects of these functions. The vowel /i/ uses the tongue shape, whereas /u/ uses tongue and lip shapes. The purpose of this study is to investigate the morphological changes of the tongue and the adaptation of pronunciation using cine MRI for speech of patients who undergo glossectomy. Material and Methods Twenty-three controls (11 males and 12 females) and 13 patients (eight males and five females) volunteered to participate in the experiment. The patients underwent glossectomy surgery for T1 or T2 lateral lingual tumors. The speech tasks “a souk” and “a geese” were spoken by all subjects providing data for the vowels /u/ and /i/. Cine MRI and speech acoustics were recorded and measured to compare the changes in the tongue with vowel acoustics after surgery. 2D measurements were made of the interlip distance, tongue-palate distance, tongue position (anterior-posterior and superior-inferior), tongue height on the left and right sides, and pharynx size. Vowel formants Fl, F2, and F3 were measured. Results The patients had significantly lower F2/Fl ratios (F=5.911, p=0.018), and lower F3/F1 ratios that approached significance. This was seen primarily in the /u/ data. Patients had flatter tongue shapes than controls with a greater effect seen in /u/ than /i/. Conclusion The patients showed complex adaptation motion in order to preserve the acoustic integrity of the vowels, and the tongue modified cavity size relationships to maintain the value of the formant frequencies.

Geographic tongue and psoriasis: clinical, histopathological, immunohistochemical and genetic correlation - a literature review

Abstract: Geographic tongue is a chronic, inflammatory, and immune-mediated oral lesion of unknown etiology. It is characterized by serpiginous white areas around the atrophic mucosa, which alternation between activity, remission and reactivation at various locations gave the names benign migratory glossitis and wandering rash of the tongue. Psoriasis is a chronic inflammatory disease with frequent cutaneous involvement and an immunogenetic basis of great importance in clinical practice. The association between geographic tongue and psoriasis has been demonstrated in various studies, based on observation of its fundamental lesions, microscopic similarity between the two conditions and the presence of a common genetic marker, human leukocyte antigen (HLA) HLA-C*06. The difficulty however in accepting the diagnosis of geographic tongue as oral psoriasis is the fact that not all patients with geographic tongue present psoriasis. Some authors believe that the prevalence of geographic tongue would be much greater if psoriatic patients underwent thorough oral examination. This study aimed to develop a literature review performed between 1980 and 2014, in which consultation of theses, dissertations and selected scientific articles were conducted through search in Scielo and Bireme databases, from Medline and Lilacs sources, relating the common characteristics between geographic tongue and psoriasis. We observed that the frequency of oral lesions is relatively common, but to establish a correct diagnosis of oral psoriasis, immunohistochemical and genetic histopathological analyzes are necessary, thus highlighting the importance of oral examination in psoriatic patients and cutaneous examination in patients with geographic tongue.

Case report: tongue gangrene and oropharyngeal carcinoma

Gangrene of the tongue is a condition rarely described in the literature. It generally occurs in association with temporal arteritis and other vasculitides. We described a rare case of tongue necrosis associated with oropharyngeal carcinoma. A 67-male patient, previously submitted to exclusive radiotherapy for a squamous cell carcinoma of the tonsillar region, was admitted to our service with high dysphagia. Computed tomography showed circumferential swelling of the oropharynx, with areas of diffuse contrast uptake and significant reduction of the vascular flow at this level, especially venous return. About 6 months after the onset of symptoms, he was submitted to an urgent tracheostomy for airway obstruction. Then, about 1 month after tracheotomy, the neck skin became ecchymotic, congested, and he started with profuse oropharyngeal bleeding and congestion and thrombosis signs in the tongue. To our knowledge, this entity has not been yet described in the literature (AU)

Case for diagnosis

The Osler-Weber-Rendu syndrome or Hereditary Hemorrhagic Telangiectasia (HHT) is a systemic fibrovascular dysplasia characterized by defects in the elastic and vascular walls of blood vessels, making them varicose and prone to disruptions. Lesions occur in different organs and can lead to hemorrhage in the lungs, digestive tract and brain. We describe the case of a patient with cutaneous manifestations and severe impairment of the digestive tract. It is important for the dermatologist to recognize this syndrome, since the cutaneous lesions may play a key role in diagnosis.

Arterio Venous Malformation of Tongue Presenting with Bleeding in Pregnancy.

Arterio venous malformation (AVM) of the tongue is a rare craniofacial vascular anomaly. It occurs due to the failure of complete involution of fetal capillary bed leading to the development of abnormal connections between arteries and veins. It can present with diff erent clinical presentations and radiographic findings. It may be overlooked at birth due to its innocent appearance. Progression of the AVMs is commonlyinduced by puberty, trauma, and pregnancy. Furthermore, some forms of treatment, including ligation of arterial feeders, partial excision, incomplete arterial embolization, and laser treatment can trigger progression of quiescent AVMs. Progression of AVMs in pregnancy can sometimes lead to torrential hemorrhage. Th is can endanger the life of the mother and fetus. We report a case of a 22-year-old primigravida referred of our institution at 35 weeks 3 days gestation with intrauterine fetal death and severe anemia, due to profuse bleeding from an AVM of the tongue.