Tongue Area Research Articles

AN UNCOMMON CAUSE OF LIP SWELLING

<h3>Introduction</h3> Angioedema is a common presentation in allergy clinic. Typical etiologies include mast cell mediated, bradykinin mediated, and idiopathic angioedema. It is important to consider less common causes and conditions that masquerade as angioedema. <h3>Case Description</h3> A 14-year-old male presented with persistent lower lip swelling. Medical history was notable for asthma, urticaria, allergic rhinitis, atopic dermatitis, and constipation. Examination showed asymmetric lower lip swelling without involvement of the tongue, uvula, or other area of the face. Laboratory work-up for suspected angioedema revealed normal CBC, elevated ESR, and normal C1 esterase inhibitor and C1 function. He tried cephalexin, mupirocin, cetirizine 20mg daily, montelukast, prednisone 50mg for 5 days and elimination of all product use on lips except for Vaseline without resolution of angioedema. A lip biopsy was obtained which revealed granulomatous cheilitis. The patient was referred to gastroenterology. Colonoscopy demonstrated granulomatous colitis and ileitis consistent with Crohn's Disease. Lip swelling resolved with adalimumab. <h3>Discussion</h3> While allergic and immunologic pathology are common causes of angioedema, this case encourages consideration of other etiologies of lip swelling, such as inflammatory bowel disease. Other diagnoses to consider include sarcoidosis, infections, miescher's cheilitis, and autoimmune conditions.

An ex-vivo study to investigate the potential of Staphylococcus epidermidis lysate to improve wound healing in diabetic patients

Appropriate treatment of non-healing diabetic foot ulcers is challenging as the whole skin repair process is complicated. Current therapeutic strategies have to be evolved for better efficacy. Staphylococcus epidermidis (S. epidermidis) is a commensal having probiotic properties. The wound healing potential of its lysate was explored using skin biopsies. Full-thickness skin, obtained from individuals with and without diabetes, was wounded using an excisional punch. Skin explants were cultured using a serum-free medium in the presence and absence of S. epidermidis lysate. The ability of the lysate to stimulate re-epithelialisation was assessed in an ex-vivo human skin model of wounding from patients with and without diabetes. Epithelial tongue length was significantly reduced in diabetic wounds in comparison to non-diabetic samples, even after 12 days post-wounding. Re-epithelialisation was augmented considerably in S. epidermidis lysate-treated wounds ex-vivo. In non-diabetic samples, the increase was twofold greater but in diabetic samples, only a slight enhancement in tongue length was observed in comparison to the control (untreated sample). The epidermal thickness also increased 7.7-fold in treated wounds in comparison to 4.4-fold in untreated samples. The cell number per unit area showed a significant increase in comparison to untreated control and the number of Ki-67 positive cells was slighter greater indicating increased expression of the proliferation marker in the newly formed epithelial tongue area in lysate-treated samples (both diabetic and non-diabetic). S. epidermidis lysate promotes re-epithelialisation in both diabetic and non-diabetic skin biopsies and may be used to accelerate healing in chronic diabetic ulcer wounds. Its therapeutic potential needs to be explored further with in vivo and molecular studies.

Bullous Type Lichen Planus: A Rare Case Report

Objective: Oral bullous lichen planus (BLP) is an uncommon form of lichen planus that affects just 1% of the oral mucosa. It is seen in oral mucous, palate, buccal mucous, and occasionally in the tongue. The purpose of this case report is the importance of including lichen planus in the differential diagnosis of leukoplakia-like lesions.Case: The presentation included lateral parts of the tongue, sublingual, and hyperkeratotic areas on the cheek, as well as asymptomatic bullous lichen planus phenomena, clinical and histological characteristics that have been present for 5 years. Systemic corticosteroid was given to the patient who had no skin symptoms. Conclusion: Burning sensation, the BLP's common clinical symptom, which is infrequently observed in the oral mucosa, may not be visible in all patients. In addition, BLP can be confused with leukoplakia when observed in plaque form. Histopathological examination is mandatory for definitive diagnosis in terms of malignant potential

Functional and morphological disorders of taste and olfaction in COVID-19 patients

ZieleTesten der Prävalenz und Entwicklung akuter olfaktorischer und gustatorischer Funktionsstörungen und ihrer morphologischen Korrelate bei COVID-19-Patienten, die aufgrund von COVID-19-bedingten Atemwegserkrankungen einen Krankenhausaufenthalt benötigen.MethodenEingeschlossen wurden 53 Krankenhauspatienten (23 Männer, 30 Frauen, Alter 42,54 ± 10,95 Jahre) mit RT-PCR-bestätigter COVID-19-Diagnose. Die Patienten wurden zweimal untersucht: direkt nach der Entlassung aus dem Krankenhaus und 4–6 Wochen später. Elektrogustometrische (EGM-)Schwellen im von der Chorda tympani versorgten Zungenbereich, am weichen Gaumen und im Bereich der Papillae vallatae wurden beidseitig erfasst. Der Geruchssinn wurde mit Riechstäbchen untersucht (Sniffin’ Sticks, Burghart GmbH, Wedel, Deutschland). Mittels Kontaktendoskopie wurden die Nasen- und Mundschleimhäute (fungiforme Papillen, fPap) der Patienten untersucht. Die Ergebnisse wurden mit denen von 53 gesunden Personen verglichen (23 Männer, 30 Frauen, Alter 42,90 ± 10,64 Jahre).ErgebnisseDie EGM-Schwellenwerte der Patienten waren in beiden Fällen signifikant höher als die der gesunden Probanden. Die EGM-Schwellenwerte bei der 2. Messung waren signifikant niedriger als bei der 1. Messung. Dementsprechend waren die vom Patienten berichteten gustatorischen Ergebnisse bei der 2. Messung verbessert. Dasselbe Muster wurde bei der Verwendung von Sniffin’ Sticks gefunden. Signifikante Veränderungen in Form und Vaskularisierung von fPap wurden bei Patienten festgestellt, insbesondere beim 1. Mal. Bemerkenswert ist, dass keine signifikanten Unterschiede in der Vaskularisation der Nasenschleimhaut der Patienten beobachtet wurden.SchlussfolgerungCOVID-19 beeinträchtigt sowohl die Geschmacks- als auch die Geruchsfunktion. Es beeinflusst auch parallel die Struktur und Vaskularisierung der Mundschleimhaut, wenn auch die Nasenschleimhaut in einem viel geringeren, nicht signifikanten Ausmaß. Unsere Ergebnisse deuten darauf hin, dass COVID-19 eine leichte bis schwere Neuropathie mehrerer Hirnnerven verursachen kann.

Quantitative Scintigraphy Imaging of Lingual Raynaud’s Phenomenon Using 3-Dimensional-Ring Cadmium-Zinc-Telluride Single-Photon Emission Computed Tomography/Computed Tomography

Perfusion scintigraphy with the acquisition of planar blood flow and pool images of bilateral hands has been used to aid diagnosis and to evaluate treatment response to Raynaud’s phenomenon (decreased blood flow to hand or foot). However, because of the difficulty in imaging the tongue area with a conventional gamma camera, perfusion scintigraphy imaging of patients with lingual Raynaud’s phenomenon has yet to be reported. Here, we report the case of a 59-year-old man with lingual Raynaud’s phenomenon in which blood pool imaging of the tongue was performed using three-dimensional (3D)-ring cadmium-zinc-telluride (CZT) single-photon emission computed tomography/computed tomography (SPECT/CT). During follow-up, the patient’s lingual symptoms had worsened, and follow-up blood pool SPECT/CT images also revealed decreased blood pool uptake of the tongue, showing a decreased blood pool of more than 25% on quantitative analysis. This case suggests that blood pool imaging of the tongue using 3D-ring CZT SPECT/CT has clinical significance in evaluating patients with lingual Raynaud’s phenomenon.

The potential impact of model horizontal resolution on the simulation of atmospheric cloud radiative effect in CMIP6 models

The simulations of atmospheric cloud-radiative effect (ACRE) from 54 Coupled Model Intercomparison Project phase 6 (CMIP6) models during the historical period of 2000/03–2014/12 are compared and evaluated against the satellite-based Clouds and the Earth’s Radiant Energy System (CERES) products. For ease of comparison, all CMIP6 models are divided into high-, medium-, and low-resolution groups to examine the potential impact of model horizontal resolution change on the simulations of ACRE distribution over the tropical oceans. The results show that ACRE is positive inside the ITCZs but negative in the subtropics and cold tongue areas, owing to the very different radiative forcing between deep and shallow clouds. Simulations of ACRE are sensitive to the model horizontal resolution used and the finer resolution models generally produce a better performance of ACRE simulations against the CERES observations. The reduced ACRE biases in finer resolution models are mainly contributed by the improved longwave ACRE (i.e., LWACRE) simulations, especially over the Pacific and Atlantic cold tongue areas where shallow stratocumulus clouds prevail.

Antifungal Susceptibility of Candida albicans Isolated from Tongue and Subgingival Biofilm of Periodontitis Patients.

The subgingival biofilm, as the most complex microbial community, has been proven to be reservoir of Candida spp. The main concept of this study was to investigate if there is a difference between the sensitivity of Candida albicans (C. albicans) isolated from tongue and subgingival areas of periodontitis patients to antifungal agents. The aim of the study was to determine: (1) the distribution of different Candida species in the tongue and subgingival samples of periodontitis patients; (2) the susceptibility of Candida albicans strains from tongue and subgingival biofilm to the effects of commonly used antifungal agents: fluconazole, amphotericin B and itraconazole; (3) the correlation between the susceptibility of Candida albicans and clinical periodontal parameters. Tongue and subgingival biofilm samples of periodontitis subjects (N = 163) were examined. Susceptibility was tested when the same Candida species was isolated from both sites (17 subjects). Candida spp. were isolated in 23.3% of tongue and 21.5% of the subgingival samples. All isolates were susceptible to amphotericin B, while 64.71% of tongue and 52.94% of subgingival isolates were susceptible to fluconazole. A low frequency of itraconazole susceptibility was observed for tongue (17.64%) and subgingival isolates (11.76%). The correlations between full-mouth plaque score and Minimal Inhibitory Concentration (MIC) for tongue isolates were strongly positive for all antimycotics. Positive correlation was also observed between moderate periodontal destruction and MICs for tongue and subgingival isolates. The susceptibility of C. albicans to antifungals correlate with oral hygiene and moderate periodontal destruction. There is no difference in antifungal susceptibility between tongue and subgingival isolates.

Using the modified Schirmer test for dry mouth assessment: A cross-sectional study.

This study aimed to establish whether the modified Schirmer test could serve as a diagnostic tool for dry mouth, that is, whether it could reliably measure salivary film at selected locations within the oral cavity, and to identify levels of sensitivity/specificity and determine reference values. Therefore, a cross-sectional study (N = 120, mean age 63.5 [SD 13.9] years) was performed. The test was used at five locations (hard palate; buccal mucosa in molar region at 4 mm above occlusal plane; anterior tongue; lower lip; mouth floor), and results were recorded after 1, 2 and 3min. A statistically significant discriminatory ability of the Schirmer test for the unstimulated salivary flow rates could be shown for the palate (at 3min), buccal mucosa (at 1min), mouth floor (at 1 min), and tongue (at 2 and 3min) (areas under the curve 0.64-0.68), with individual sensitivity/specificity values depending on test location/time points. Thus, the modified Schirmer test has potential to become a simple and reproducible instrument for the detection of dry mouth based on low unstimulated salivary flow rates in dentistry and especially outreach care. Care must be taken concerning intraoral test location and measurement time.

Somatotopic Organization of Hyperdirect Pathway Projections From the Primary Motor Cortex in the Human Brain.

BackgroundThe subthalamic nucleus (STN) is an effective neurosurgical target to improve motor symptoms in Parkinson's Disease (PD) patients. MR-guided Focused Ultrasound (MRgFUS) subthalamotomy is being explored as a therapeutic alternative to Deep Brain Stimulation (DBS) of the STN. The hyperdirect pathway provides a direct connection between the cortex and the STN and is likely to play a key role in the therapeutic effects of MRgFUS intervention in PD patients.ObjectiveThis study aims to investigate the topography and somatotopy of hyperdirect pathway projections from the primary motor cortex (M1).MethodsWe used advanced multi-fiber tractography and high-resolution diffusion MRI data acquired on five subjects of the Human Connectome Project (HCP) to reconstruct hyperdirect pathway projections from M1. Two neuroanatomy experts reviewed the anatomical accuracy of the tracts. We extracted the fascicles arising from the trunk, arm, hand, face and tongue area from the reconstructed pathways. We assessed the variability among subjects based on the fractional anisotropy (FA) and mean diffusivity (MD) of the fibers. We evaluated the spatial arrangement of the different fascicles using the Dice Similarity Coefficient (DSC) of spatial overlap and the centroids of the bundles.ResultsWe successfully reconstructed hyperdirect pathway projections from M1 in all five subjects. The tracts were in agreement with the expected anatomy. We identified hyperdirect pathway fascicles projecting from the trunk, arm, hand, face and tongue area in all subjects. Tract-derived measurements showed low variability among subjects, and similar distributions of FA and MD values among the fascicles projecting from different M1 areas. We found an anterolateral somatotopic arrangement of the fascicles in the corona radiata, and an average overlap of 0.63 in the internal capsule and 0.65 in the zona incerta.ConclusionMulti-fiber tractography combined with high-resolution diffusion MRI data enables the identification of the somatotopic organization of the hyperdirect pathway. Our preliminary results suggest that the subdivisions of the hyperdirect pathway projecting from the trunk, arm, hand, face, and tongue motor area are intermixed at the level of the zona incerta and posterior limb of the internal capsule, with a predominantly overlapping topographical organization in both regions. Subject-specific knowledge of the hyperdirect pathway somatotopy could help optimize target definition in MRgFUS intervention.

Fetal Micro and Macroglossia: Defining Normal Fetal Tongue Size.

Abnormal fetal tongue size is a phenotypic feature of various syndromes including Beckwith-Wiedemann, Pierre-Robin, oromandibular limb hypoplasia, chromosomal aberrations, etc. Current data regarding normal fetal tongue size are limited. Hence, micro/macroglossia are subjectively determined. The aim of the study was to construct a contemporary fetal tongue nomogram and to assess its clinical contribution. A prospective cross-sectional study was performed in well dated, low risk, singleton pregnancies. Fetal tongues were measured by 5 trained sonographers. Highest quality images were selected. Intra- and interobserver variability was assessed. Tongue length, width, area, and circumference 1st to 99th centiles were calculated for each gestational week. Based on the normal tongue size charts, we created a Tongue Centile Calculator. Over 18months, 664 tongue measurements were performed. A cubic polynomial regression model best described the correlation between tongue size and gestational age. The correlation coefficient (r2 ) was 0.934, 0.932, 0.925, and 0.953 for tongue length, width, area, and circumference, respectively (P< .001). Intra- and interobserver variability had high interclass correlation coefficients (>0.9). Using the new charts, we were able to identify 2 cases of macroglossia, subsequently diagnosed with Beckwith-Wiedemann, and 4 cases of microglossia, 3 associated with Pierre-Robin sequence, and 1 associated with persistent buccopharyngeal membrane. We present novel fetal tongue size charts from 13 to 40 weeks of gestation. Clinical application of these nomograms may be beneficial in the prenatal diagnosis of syndromes or malformations associated with abnormal fetal tongue size.

Laporan Kasus: Glossitis pada Penderita Anemia Defisiensi Besi

Anemia is a common hematological disorder. Anemia is a disorder in which erythrocytes or circulating hemoglobin cannot fulfill their function properly. A 21-year-old woman came to the General Sudirman University Dental and Oral Hospital with complaints of dizziness, weakness, pale face, burning tongue in the oral cavity, stinging sensation on the dorsum of the tongue, and getting sicker when eating spicy food. spicy or hot. Symptoms have been coming and going since last year. Complete blood count was performed and the patient was diagnosed with glossitis due to iron deficiency anemia. Discussion: Glossitis is an inflammation of the tongue characterized by depapilation of the tongue accompanied by pain or burning in the tongue area. Glossitis is one of the oral manifestations of iron deficiency anemia. Patients with anemia can experience glossitis. The therapy given is instructions to the patient to consume foods rich in iron.

Macroglossia

A 59-year-old man sought treatment for swollen tongue and bilateral submandibular areas of 6-months' duration. The enlarged tongue led to dysphagia without pain. The patient reported that the swelling fluctuated between mild and severe. The patient had a history of hypertension and diabetes for 10 years. Calcium channel blockers controlled the hypertension, and glycemic status was well controlled via lifestyle intervention, with fasting blood glucose maintained at below 6 mmol/L. In addition, the patient had undergone cardiac surgery for myocardial infarction 5 years earlier and took aspirin regularly.

Research on the energy characteristics of reactor coolant pump under flow coastdown transient

In order to research the energy characteristics in impeller, guide vane and volute of reactor coolant pump under flow coastdown transient. In four typical states the variation laws of dynamic–static pressure energy and entropy generation in hydraulic components were analyzed under flow coastdown transient. The results show that after the occurrence of flow coastdown transient, the decreasing rate of energy conversion efficiency of impeller is similar that of the rotating speed. With the development of flow coastdown process, the high dynamic pressure energy distribution of impeller deviates to the outlet of impeller. After 0.25TQi, the energy retained by impeller is basically consumed. In guide vane passage, the change of dynamic pressure energy first increases and then decreases, and the static pressure energy firstly decreases and then increases. After 0.75TQi, the diffusivity of the guide vanes to the fluid decreases rapidly. With the development of flow coastdown process, the main working area of guide vane gradually shifts from the middle of guide vane to outlet. High static pressure energy area at guide vane inlet is enlarged and then reduced. With the development of flow coastdown process, the dynamic pressure energy of V2 and V4 at the monitoring points of volute changes alternately, and the dynamic pressure energy of right tongue region of volute gradually exceeds 11.20 m, and the energy conversion effect of volute gradually weakens, and the low static pressure energy region of the right tongue gradually disappears. Compared with other conditions, at 1.0TQi, the loss of dynamic pressure energy in volute is faster, while the reduction rate of static pressure energy is more stable. Entropy generation in reactor coolant pump varies in a similar manner to flow rate and speed, and is closely related to dynamic-static pressure energy. Both Total Entropy Generation (TEG) and per unit volume of entropy generation (Sˈ) eventually approach zero. Entropy generation ratio of volute is much larger than that of other areas, accounting for more than 60%. Guide vane area generates more per unit volume of energy loss than other areas. The flow in impeller under 0.5TQi condition is more stable than that under other conditions. The unstable flow in reactor coolant pump at the initial stage of flow coastdown transient is more severe and has a greater energy loss than under other conditions. After flow coastdown, great damage may occur in the impeller blade inlet area, the guide blade inlet area, the left area of the volute and the volute tongue area.

Experimental Study on Operational Stability of Centrifugal Pumps of Varying Impeller Types Based on External Characteristic, Pressure Pulsation and Vibration Characteristic Tests

This study performed external characteristics, dynamic pressure, and vibration tests on the closed impeller model, semi-open type impeller model, and open impeller model in order to study the influence of the impeller structure on the operational stability of the pump. According to the research findings, the external characteristics of the three impellers enjoyed favorable stability with flat curves under low flow rates. As the flow increases, the stability of the external characteristics weakens, and the poorest stability can be observed in the open impeller, while the enclosed impeller has the best stability under a large flow rate. In addition, intense pressure fluctuations arise near the casing tongue due to the dynamic and static interference between the blade and the casing tongue, causing a large amplitude of pressure pulsation near the casing tongue and the pump outlet. It can be seen that the stability of pressure pulsation of the closed impeller in the casing tongue area was the best, whereas the stability of pressure pulsation of the open impeller was the poorest. The minimum casing vibration can be found in the closed impeller, followed by the semi-open impeller, and the open impeller, with the maximum vibration. In addition, the optimum stability of rotor vibration can be observed in the closed impeller, semi-open impeller, and open impeller with similar stability of rotor vibration.

Therapeutic effect of laparoscopic sleeve gastrectomy on obstructive sleep apnea and relationship of type 2 diabetes in Japanese patients with severe obesity.

Aims/IntroductionObstructive sleep apnea (OSA) is among the most important obesity‐related diseases, and offers the potential for accelerated the early onset and progression of type 2 diabetes. The aim of the present study was to clarify the therapeutic effect of laparoscopic sleeve gastrectomy on OSA in severely obese Japanese patients, and to find correlations between OSA improvements and β‐cell function (BCF).Materials and MethodsBetween September 2013 and December 2019, 61 patients who underwent laparoscopic sleeve gastrectomy were enrolled. The apnea–hypopnea index (AHI) was used to diagnose OSA. The tongue area, uvula area and other parameters were measured using cone‐beam computed tomography. Regarding BCF parameters, the homeostasis model assessment of β‐cell function, insulinogenic, Matsuda and disposition indexes were used to evaluate the improvement in BCF. Improvement of OSA was defined as AHI <15.ResultsThe improvement rate of OSA was 51.8% (29/56). The change in AHI was significantly correlated with the excess weight loss percentage (ρ = 0.501), changes in tongue area (ρ = 0.350) and uvula area (ρ = 0.341). Multivariate analysis showed that preoperative AHI and postoperative hemoglobin A1c were independent prognostic factors of OSA non‐improvement. The homeostasis model assessment of β‐cell function (P < 0.001), the insulinogenic index (P < 0.001) and the disposition index (P = 0.019) of patients with AHI of <15 were significantly higher than those in patients with AHI of ≥15.ConclusionsLaparoscopic sleeve gastrectomy is a promising procedure for severely obese patients with OSA. BCF recovery was found to be significantly higher in patients with OSA improvement.

12 Years of Area Variation by the Drygalski Ice Tongue as Measured With COSMO-SkyMed

One important coastal polynya around Antarctica is Terra Nova Bay (TNB) polynya. Its formation and persistence are due to the combined effect of katabatic winds, regional ice conditions, and the Drygalski Ice Tongue (DIT). The combined effect of these elements arranges a delicate balance in Terra Nova Bay. To evaluate the interacting elements, we focused our attention on the Drygalski Ice Tongue, one of the largest ice tongues in Antarctica. The DIT is a 70-kilometre long tongue which juts out like a pier from the icy land into northern McMurdo Sound of Antarctica's Ross Dependency. The analysis presented in this paper was carried out using Cosmo-SkyMed (CSK) images. The methodology developed for the analysis consists of three steps: 1) DIT shape enhancement, 2) fuzzy Bayesian segmentation which associates the analysed set of pixels with a binary label field, and 3) parametric representation of the shape of the DIT to compare the area of the ice tongue as it was 12 years ago and as it is today. The computed mean value of the DIT surface velocity was 703 m y <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">-1</sup> . To estimate the closeness of the derived parameter to the true value, using a statistical approach, the 95% confidence interval for the true mean value is 703±4.236 m y <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">-1</sup> . Our analysis confirms a trend of advance. That is, after the significant calving events of the tongue in 2005 and 2006, the DIT has resumed its normal growth, and its length has increased by 12% in the last 12 years.

Contactless non-invasive method to identify abnormal tongue area using &lt;i&gt;K&lt;/i&gt;-mean and problem identification in COVID-19 scenario

Contactless non-invasive method to identify abnormal tongue area using &lt;i&gt;K&lt;/i&gt;-mean and problem identification in COVID-19 scenario

Burning mouth syndrome: a review of therapeutic approach.

Burning mouth syndrome (BMS) is described by an intense burning sensation of the tongue or other oral areas without a clear etiopathology. The diagnosis of BMS is challenging due to variations of manifestations. The management of BMS is complicated due to the complex etiology of the disease. Many medications and treatment methods have been recommended for BMS management, but no one confirmed as the standard method. In this study, the therapeutic approaches of BMS were evaluated. The data of the article was obtained from PubMed/MEDLINE, Cochrane Library, and Web of Science. The following terms including "burning mouth syndrome", "therapy", and "treatment" were used for search in the databases. A wide range of articles about the therapeutic approach of BMS was searched and reviewed. Pharmacological and non-pharmacological approaches have been used for BMS management. Pharmacological treatments are including Capsaicin, Clonazepam, Low-dose aripiprazole, Alpha-lipoic acid, Duloxetine, Amitriptyline, Gabapentin, and Pregabalin, and ultra-micronized palmitoylethanolamide. Non-pharmacological therapies for BMS are cognitive therapy, Electroconvulsive therapy, Laser therapy, Acupuncture and auriculotherapy, Transcranial Magnetic Stimulation (rTMS), Salivary Mechanical Stimulation, and Botulinum Toxin. A detailed assessment of the etiology and pathophysiology of BMS, and having information about novel therapeutic interventions are essential for the management of BMS.

Applicability of the Geographic Tongue Area and Severity Index among Healthcare Professionals: A Cross-Sectional Clinical Validation of a Newly Developed Geographic Tongue Scoring System.

Geographic tongue (GT) is a chronic condition of unknown aetiology, with no defined parameters to establish the protocol for evidence-based management. Validation of a newly developed and proposed clinical index to assess the severity of GT could assist in its diagnosis, especially in cases associated with systemic dermatological diseases in the form of psoriasis. Objective: To verify the applicability of the geographic tongue area and severity index (GTASI). This involved healthcare professionals from different specialties to evaluate the usefulness of the GTASI in supporting GT classification, as well as the follow-up process. Methods: One hundred cases of previously diagnosed GT were initially evaluated by three independent, experienced researchers/clinicians to obtain a standardised classification baseline. Subsequently, nine cases of GT were selected, three cases for each category—mild, moderate and severe. These stages were professionally evaluated by 51 healthcare professionals from three groups: 17 dentists (33%), 22 oral medicine specialists (43%) and 12 specialist dermatologists (24%) during a cross-sectional survey. Results: The quantitative and qualitative assessment based on experts’ opinions in the cross-sectional survey demonstrated an acceptable, similar level of GT clinical diagnosis (p > 0.05), with coherence between the various groups of professionals critically appraising the GTASI. An apparent divergence was observed for the moderate GT category, as well as in the group of less experienced evaluators. Conclusion: Whilst the validation of GTASI applicability was successfully executed, the general dental practitioners, specialists in oral medicine and dermatologists were equally capable of correct GT diagnosis and appropriately rating its severity. These coherent results were especially replicated among the experienced clinicians. The validation of the newly proposed index confirmed its reliability as a feasible instrument in oral medicine, with the prospect of its wider implementation in clinical practice.

Comprehensive treatment of glossodynia using vacuum therapy

Relevance. This article evaluates the effectiveness of vacuum therapy in the comprehensive treatment of glossodynia by assessing tongue tissue oxygen saturation and oral fluid noradrenaline content.Materials and methods. 65 patients with glossodynia, aged from 42 to 70 years old, comprised control (n = 32) and comparison (n = 33) groups. The control group received only medication therapy, while the comparison group also received vacuum therapy. Medication therapy included antianxiety drugs, antidepressants, vitamins and dental gel. The study used a CAP-“Periodontist” unit for physiotherapy treatment. Vacuum acted upon painful tongue areas with pressure 0.35-0.45 atm during 1.5-8 min daily (time and vacuum gradually increased within the specified range). The treatment cycle consisted of 7 sessions. We assessed the pain level by VAS (visual analogue scale). We evaluated parameters of peripheral oxygen saturation by pulse oximetry. We checked noradrenaline in the oral fluid by high-performance liquid chromatography using a liquid chromatograph with an electrochemical detector.Results. In the control group, values of peripheral oxygen saturation, noradrenaline content in the oral fluid and pain level after treatment differed from the corresponding values in the comparison group (p &lt; 0,001).Conclusion. Comprehensive treatment of glossodynia, with vacuum therapy, is effective and significantly decreases tingling and numbness, improves microcirculation and patient psychoemotional condition due to pain relief.