The tongue is a muscular organ that sits on the floor of the oropharynx. It is enveloped by mucosa and contains glands, sensory organs, and four pairs of extrinsic muscles. The tongue is essential for several important functions, including jaw articulation, taste, manipulation of food, swallowing, and the production of speech. See image below.
Tongue anatomy in cross-section. The epithelial surfaces comprise the mucosa.
From anterior to posterior, the tongue has 3 surfaces: tip, body, and base. The tip is the highly mobile, pointed anterior portion of the tongue. Posterior to the tip lies the body of the tongue, which has dorsal (superior) and ventral (inferior) surfaces. For more information about the relevant anatomy, see Tongue Anatomy.
Injuries to the tongue are often treated in the emergency department or other acute care settings. A tongue laceration is often the result of a fall, seizure, psychogenic nonepileptic seizure, or other blunt or penetrating force mechanism.
Piercings, intoxication, and iatrogenic cause are also commonly associated with tongue injury.
Case studies have also implicated dystonia, self-mutilation, anesthesia, and exploding electronic cigarettes.
Lacerations secondary to seizures are most often found to the side of the tongue.
Because of the tongue’s generous blood supply, most tongue lacerations do not become infected and many heal well without repair. The tongue hypertrophies to rebulk itself in a period of 6 months, so even loss of lateral tongue and tip often produces no permanent deficit.
However, repair is required when the injury has certain characteristics (see Indications).
The goals of laceration repair of the tongue are to attain adequate closure, stop bleeding, minimize complications, preserve mobility, and optimize articulation and deglutition.
While uncommon, practitioners should keep in mind that such injuries can be the result of physical abuse.
Oral and facial trauma occur in 50% of abused children.