base of the tongue
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Author(s):  
Benoit Brazey ◽  
Yassine Haddab ◽  
Laure Koebel ◽  
Nabil Zemiti

Abstract The presence of a tumor in the tongue is a pathology that requires surgical intervention from a certain stage. This type of surgery is difficult to perform because of the limited space available around the base of the tongue for the insertion of surgical tools. During the procedure, the surgeon has to stretch and then fix the tongue firmly in order to optimize the available space and prevent tissue movement. As a result, the preoperative images of the inside of the tongue no longer give a reliable indication of the position and shape of the cancerous tissue due to the deformation of the overall tissue in the area. Thus, new images are needed during the operation, but are very difficult to obtain using conventional techniques due to the presence of surgical tools. Electrical Impedance Tomography (EIT) is an imaging technique that maps the resistivity or difference of resistivity of biological tissues from electrical signals. The small size of the electrodes makes it a potentially interesting tool to obtain intraoperative images of the inside of the tongue. In this paper, the possibility of using EIT for this purpose is investigated. A detection method is proposed, including an original configuration of the electrodes, consistent with the anatomical specificities of the tongue. The proposed method is studied in simulation and then a proof of concept is obtained experimentally on a 3D printed test tank filled with saline solution and plant fibres.


2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Kaoutar Cherrabi ◽  
Zouheir Zaki ◽  
Mohamed Noureddine El Alami

Abstract Background Foreign body inclusions are rare in head and neck. They are challenging in regard to anatomical risks and surgical approaches. This is the case of a particular foreign body with a curious trajectory, associated with a brief review of anatomical risks and surgical approaches. Case presentation This is the case of a 25-year-old male who has been attacked with a sharp object, which caused an inclusion of a part of the foreign body in the sub-mental and pharyngeal areas. The clinical exam showed a painful bulging in the sub-mental area, with moderately hemorrhagic sputum and difficulty while swallowing. The intra-oral exam showed a foreign body that was located at the right side of the base of the tongue, and which goes backwards and outwards to penetrate retro-pharyngeal mucosa. The patients underwent an angio-CT scan, which showed a curious fine and sharp metallic object, without direct signs of lesions to the jugular vein or carotid artery or any collateral branches. The patient underwent extraction through cervical approach, with satisfying bleeding control. Intra-oral exploration showed a retro-pharyngeal lesion of 2 cm, without particular bleeding. The cervical lesion and retro-pharyngeal lesions were closed. The lesion at the base of the tongue was of 1 cm, palpable but not accessible to sutures, and a naso-pharyngeal tube was inserted. The patient presented very satisfying post-operative outcome, without any complications. Conclusion When dealing with foreign bodies of head and neck, physicians must be precocious and prepared for the risk of bleeding after extraction. Thorough radiological exploration is necessary as long as the patient is stable. Direct and indirect radiological signs allow the clinician to understand the nature and the trajectory of the object, as well as the damage to collateral structures.


2021 ◽  
pp. 439-441
Author(s):  
Megasiwi Megasiwi ◽  
Widyanti Soewoto ◽  
Galih Santoso Putra

Rhabdomyosarcoma (RMS) is the third most common solid organ malignancy in children after Wilms tumor and neuroblastoma. It is a highly malignant tumor with local tissue invasion and lymphatic and hematogenous metastases. The main treatment for RMS is complete resection with a combination of chemotherapy and radiotherapy. Here, we present the case of a 2-year-old girl who came to the hospital with a complaint of noisy breathing (Stridor) for the past 2 weeks. Intraoral examination showed an oval mass at the base of the tongue that almost closed the airway, felt soft, and had a bump. A computed tomography scan of the neck was performed, and a solid lesion with clear irregular borders was found in the posterior lingua. Incisional biopsy was performed with histopathological results of embryonal RMS. Two weeks after the biopsy, chemotherapy was performed, and the evaluation after two chemotherapy sessions, the mass size was found to have decreased.


Author(s):  
Javier Arredondo Montero ◽  
Mónica Bronte Anaut ◽  
Natalia López-Andrés ◽  
Nerea Martín-Calvo ◽  
Carlos Bardají Pascual
Keyword(s):  

2021 ◽  
pp. 261-292
Author(s):  
Daniel R. van Gijn ◽  
Jonathan Dunne

The larynx, trachea and bronchi develop embryologically from the foregut in the form of an outpouching during the fourth week of gestation. The larynx bridges the gap from the base of the tongue above, to the trachea below lying within the hypopharynx. It sits in the neck spanning the distance from the third to sixth cervical vertebrae. It is a complex respiratory organ composed of a cartilage framework, ligaments, intrinsic and extrinsic muscles and is lined by an epithelial mucous membrane continuous above with the pharynx and below with the trachea. Its primary function is protection of the lower respiratory tract against aspiration. It allows the generation of a high intrathoracic pressure required for coughing, straining and lifting (Valsalva manoeuvre) and phonation. The anatomy of the larynx can either be considered by its surgical division of the supraglottis, glottis and subglottis (these landmarks are important in the consideration of cancer spread).


2021 ◽  
Vol 6 (3) ◽  
pp. 223-225
Author(s):  
Neelam Gupta ◽  
Ankush Blaggan ◽  
Vikas Dubey ◽  
Mehak Kashyap ◽  
Nechal Kaur

Hamartomas are benign proliferative lesions with no metastatic properties. The hamartoma of the tongue is usually rare. It is usually difficult to diagnose grossly. But can be diagnosed definitely with help of histopathological examination. Our case study is on a 5-year-old female who was asymptomatic and presented with cystic swelling at the base of the tongue which was initially diagnosed as a cyst but was diagnosed histopathologically as a hamartoma.


2021 ◽  
Vol 14 (9) ◽  
pp. e244844
Author(s):  
Benjamin Denoiseux ◽  
Philippe Van Camp ◽  
Michel Bila ◽  
Constantinus Politis

A 55-year-old man initially presented with an undifferentiated, HPV-p16-negative squamous cell carcinoma (SCC) in the left tonsillar region (cT4a N0 M0), which was treated with a combination of radiotherapy and chemotherapy. Several months later, the patient developed osteoradionecrosis on the left side of the mandible as well as a second primary lesion at the left base of the tongue. Surgical resection and mandibular reconstruction with a free vascularised fibula flap was performed. Regional clinical and radiologic follow-up showed no signs of tumour recurrence. However, routine positron emission tomography (PET)-CT showed a hypermetabolic mass intracardially. MRI confirmed the presence of a mass intramurally in the left ventricle, highly indicative of metastasis. Cardiac metastasis following oral cancer is rare and usually asymptomatic. Therefore, it can be missed easily and is mostly described as a finding postmortem. Reporting these cases is important for contributing to the insight into the uncommon development of metastasis.


2021 ◽  
Vol 3 (3) ◽  
pp. 96-99
Author(s):  
O. Oulghoul ◽  
F. Hadid ◽  
O. Benhoummad ◽  
Y. Rochdi ◽  
A. Raji

Introduction: Cystic lymphangioma or cystic hygroma is a congenital malformation of the lymphatic system that manifests as a soft, benign, and painless mass. It originates from remnants of embryonic lymphatic tissue that retains the potential for proliferation. Material and methods: Our retrospective study involved 16 cases of cystic lymphangioma managed between 2017 and 2020. Results: This study included 9 girls and 7 boys with a mean age of 4.2 years. Cystic lymphangioma was visible in 7 cases at birth and in 6 cases before the age of 2 years, and beyond 2 years in 3 cases. The tumor was cervical in 11 cases, including one case of parotid extension, and 02 cases of sub maxillary extension, jugal in one and one case of parotid localization, and one case of lingual localization. Surgical indication was based on clinical examination and imaging in all cases. Excision was considered complete in 12 cases and incomplete in four cases. In three cases, excision was difficult due to adhesion to the internal jugular vein and the carotid bifurcation, base of the tongue in one case and facial nerve in one case. Early complications were, hematoma [one case], lymphorrhea [one case], jugal recurrence [one case] nine months after surgical excision. Conclusion: Cervico-facial cystic lymphangioma is a particular pathology whose management is challenging, complex and multidisciplinary.


2021 ◽  
Vol 1 (1) ◽  
pp. 3-10
Author(s):  
Alina Mihaela CĂLIN ◽  
◽  
Anamaria ZAHARESCU ◽  
Manole PALIVAN ◽  
◽  
...  

In order to receive the food bolus, the muscular-fibrous walls of the pharynx contract by reflex, first widening the pharynx, and the palatine veil rises, closing the passage to the rhinopharynx. Then the base of the tongue rises, the piers approach, closing the bucco-pharyngeal passage in the isthmus. The airway is simultaneously interrupted by the posterior displacement of the base of the tongue, the folding of the mucosa of the posterior pharynx, and the lifting and closing of the larynx. The food bolus is thus forced to follow the hypopharyngeal-esophageal pathway, the only one that remains open. In case of paralysis of the nerves that coordinate the swallowing process, the laryngeal sphincter remains open, favoring the false pathway and aspiration bronchopneumonias. The paralysis of the palatine veil prevents its horizontalization during swallowing, which favors the discharge of fluids into the nose, which is significant when the paralysis is bilateral and more discrete when it is unilateral. The clinical prospective and retrospective study material was represented by a number of 190 individuals aged 0 to 80 years, who were hospitalized between 01.01.2011 and 31.12.2019 in the ENT Department of the Teaching Hospital in Galați for follow-up of malignant rhinopharyngeal tumors. Most of these patients subsequently underwent sequential examination to determine their treatment response. Due to its deep location and limited clinical accessibility, onset symptoms are often absent or inconclusive for both the physician and the patient. CT scan is superior to clinical examination in primary tumor evaluation, especially in advanced T3 and T4 cases, which are largely clinically under-rated. Performing the coronal rhinopharynx sections and double-window recording greatly increase the accuracy of examination and they should be considered at least for the initial assessment procedure.


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