Parenchymatous glossitis: A case report.

We present a case of parenchymatous glossitis with unilateral severe inflammation of the hyoglossus muscle, resulting in laryngeal edema. The route of inflammation was unique. Contrast-enhanced CT was useful for diagnosis. Administration of sensitive antibiotics led to improvement. Creatine phosphokinase may be an indicator of diagnosis and treatment response.

The Journey of the Lingual Artery from the Neck to the Oral Cavity: A Cadaveric Study.

Study Design: Descriptive cross-sectional. Objective: The origin of the lingual artery (LA) has been well studied due to its implication in neck dissection, but the course thereafter to the oral cavity is less described. This cadaveric study traced the journey of the LA from the external carotid artery to its terminal branches in the tongue. Methods: Following bilateral neck dissections in 35 black Kenyan cadavers, the incidence of Beclard's, Lesser's and Pirogoff's triangles, the types of LA origin with its length, relationship to the hyoglossus muscle and anastomosis with other vessels were documented. Results: Beclard's triangle was found in 64 dissections (91.42%), Lesser's in 46 dissections (65.71%) and Pirogoff's in 39 dissections (55.71%). The LA presented either as a solitary branch (67.15%) or as a branch of either the linguofacial (LFT-24.29%), thyrolingual (TLT-2.72%) or thyrolinguofacial (TLFT-2.86%) trunk. The solitary LA was the longest at 6.93 mm, followed by the TLT branch (6.58 mm), LFT branch (6.12 mm) and TLFT branch (5.65 mm). The majority of solitary LA and LA branches of LFT and TLFT passed through the hyoglossus, while all LA branches of the TLT coursed medial to the muscle. All variants of LA have been found to anastomose with the submental artery (SMA) at frequencies that ranged from 11.10% to 100%. Conclusions: The LA was found in all cadavers and all Beclards' triangles. There is a significant incidence of LFT and TLFT variants in the Kenyan population. The LA passed either through or medial to the hyoglossus with no lateral relationship being observed.

Intramuscular myxoma of the hyoglossus muscle: A case report and literature review.

Intramuscular myxoma (IM) is a benign intramuscular neoplasm composed of fibroblasts and abundant myxoid stroma. IMs most commonly affect larger skeletal muscles, while those affecting the oral and maxillofacial regions are rare, with a small number of documented cases in the available literature. The aim of the present study was to describe a highly rare case of an IM within the hyoglossus muscle of the tongue in a 74-year-old male. The patient presented with a painless mass in the submental space that had been growing slowly for more than five years. A computed tomography scan revealed a hypodense lesion located in the root of the tongue. The mass was easily excised with thin margins, including only a small amount of the adjacent muscle tissue. The pathological diagnosis of the mass was an IM. The patient made an excellent recovery following the surgery and the follow-up three years later revealed no local recurrence. IMs of the hyoglossus muscle are highly rare, however must be considered in the differential diagnosis of swellings in the root of the tongue region.

Human tongue neuroanatomy: Nerve supply and motor endplates.

The human tongue has a critical role in speech, swallowing, and respiration, however, its motor control is poorly understood. Fundamental gaps include detailed information on the course of the hypoglossal (XII) nerve within the tongue, the branches of the XII nerve within each tongue muscle, and the type and arrangement of motor endplates (MEP) within each muscle. In this study, five adult human tongues were processed with Sihler's stain, a whole-mount nerve staining technique, to map out the entire intra-lingual course of the XII nerve and its branches. An additional five specimens were microdissected into individual muscles and stained with acetylcholinesterase and silver staining to study their MEP morphology and banding patterns. Using these techniques the course of the entire XII nerve was mapped from the main nerve to the smallest intramuscular branches. It was found that the human tongue innervation is extremely dense and complex. Although the basic mammalian pattern of XII is conserved in humans, there are notable differences. In addition, many muscle fibers contained multiple en grappe MEP, suggesting that they are some variant of the highly specialized slow tonic muscle fiber type. The transverse muscle group that comprises the core of the tongue appears to have the most complex innervation and has the highest percentage of en grappe MEP. In summary, the innervation of the human tongue has specializations not reported in other mammalian tongues, including nonhuman primates. These specializations appear to allow for fine motor control of tongue shape.

Bilateral comunications of the paralingual space / Comunicaciones bilaterales del espacio paralingual

Paralingual Space is a region located on the floor of the oral cavity. The cavity has great importance in communications and for the spread of infectious diseases. This study investigated the level of dissemination of 0.2 ml of an oily pigment solution, into paralingual space of 20 heads of male Sprague Dawley rats. The results can be seen by the spread of the solution in the three segments of paralingual space, being higher in the middle third of the region, although the differences were not significant (p<0.05). With these observations, the discussion is about the possibility that an infection may spread into paralingual space opposite the muscles of the medial wall of this space.

El espacio paralingual es una región ubicada en el piso de la cavidad oral con comunicaciones de gran importancia para la difusión de procesos infecciosos. El presente estudio investigó el nivel de difusión de 0,2 ml de una solución oleosa pigmentada, hacia el espacio paralingual opuesto en 20 cabezas de ratas Sprague Dawley. En los resultados obtenidos se observa la difusión de la solución en los tres segmentos del espacio paralingual, siendo mayor en el tercio medio de la región, aunque las diferencias no resultaron significativas (p<0,05). Con estas observaciones se discute acerca de la posibilidad de que un proceso infeccioso pueda difundir hacia el espacio paralingual opuesto a través de la musculatura de la pared medial del espacio.

Topographical Morphology of the Lingual Artery in Korean / 체질인류학회지

In order to clarify the topographical morphology of the Korean lingual artery related to clinical problems, authors investigated the morphological variations of the lingual artery through the dissection of the deep layer of head and neck. 61 -sides of Korean adult cadavers (mean age 57.8) were used for this study. The morphlogy of the origin sites of the lingual artery were classified into three types. The cases that the superior thyroid, lingual, and facial artery were originated independently from the external carotid artery were most common (56.3%). Others were the cases that the lingual artery and the facial artery were divided from the linguofacial trunk (31.2%), and the cases that the superior thyroid artery and the lingual artery were divided from the thyreolingual trunk (12.5%) from the external carotid artery, respectively. In the topographical relationships between the first part of the lingual artery and the hyoglossus muscle, the cases that the first part of the lingual artery formed loop posterior to the hyoglossus muscle (41.2%) and the cases that the lingual artery penetrated into the medial aspect of the hyoglossus muscle passing the posterior border of this muscle (66.1%) were observed most frequently. Others were the cases that the lingual artery penetrated into the posterior muscle fiber (18.6%) and the middle muscle fiber (15.3%) of the hyoglossus muscle. The courses of the second part of the lingual artery deep to the hyoglossus muscle could be classified into two morphlogical types. One was that the second part of the lingual artery ran superiorly from the origin site and then turned abruptly towards deep portion of hyoglossus muscle. In these cases, the artery turned upward again at the inside of the muscle, and then reached to the sublingual region (42.6%). The other cases were that the lingual artery ran gradually to the medial and superior aspect of the sublingual region (57.4%). The prevalency of the sublingual arteries originating from the lingual arteries was 59%. Taken all together, authors concluded that the mouth floors of Korean are supplied by both the lingual and facial artery. So, performing the hemostatic procedures in the mouth floor region, the surgeon must take a topographical anatomy of this region related the arterial supply into account.