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Background Children with tongue injuries often visit the pediatric emergency department. The vast majority of cases can be conservatively treated, while some injuries require operative repair. The aim of this article was to demonstrate a “back-to-basics” approach to a refractory bifid tongue injury in a toddler. Case description A 1-year-old toddler with a tongue injury was unsuccessfully treated three times within a week by a surgeon in another specialty; all reconstructions were mucosal only. The case was then referred to our maxillofacial unit for proper management. On examination, the recurrent injury seemed to occur because of the patient's self-biting habit. We performed the fourth reconstruction of the tongue muscles and mucosa, and because of no dental prosthetic laboratory available in our hospital, we used transparent adhesive drapes fixed by resorbable sutures to cover the patient's anterior teeth instead of bite guards. The toddler was fed via a nasogastric tube for 1 week under 2-day antibiotic prophylaxis and routine oral care. The patient was discharged without any complications 1 week later. Conclusions and practical implications The causes of repeated orofacial injuries should be identified and require particular attention to establish a proper treatment. For intraoral injuries in pediatric patients, self-biting habits should not be overlooked. The application of materials in an operating theater can help the treating clinicians improve the treatment outcomes.

Objective The aim of the current study was to compare the risk and also the types of ictal injuries in three groups of people with seizures [i.e., IGE vs. TLE vs. FS]. Methods This was a retrospective study. All patients with an electro-clinical diagnosis of IGE, TLE, or FS were recruited at the outpatient epilepsy clinic at Shiraz University of Medical Sciences, Shiraz, Iran, from 2008 until 2020. Age, sex, age at seizure onset, seizure type(s), and occurrence of ictal injury at any time since the onset of the seizures and its characteristics were registered routinely for all patients at the time of the first visit. Results One thousand and one hundred seventy-four patients were studied (481 patients with IGE, 402 people with TLE, and 291 persons with FS). While the groups differed in their demographic and clinical characteristics, the rates of ictal injury did not differ significantly between the groups. Tongue injury was more frequently reported by patients with TLE compared with that by people with IGE or FS. Other types/locations of ictal injury were more or less reported by all three groups of the patients. Conclusion Ictal injuries may happen with more or less similar rates among people with epilepsy (IGE and TLE) and those with FS. Ictal injury (rate, type, or location) should not be used as a marker for any specific diagnosis among people with seizures.

Objective To understand risk and possible mechanisms of thermal injury to the tongue during suspension laryngoscopy. Study Design and Setting Tongue injury was noted following suspension laryngoscopy in a cluster of cases; the findings raised suspicion for thermal injury. To characterize the potential for thermal injury, a lighted laryngoscope was placed in contact with samples of tongue. Tissue heating was recorded over time at fixed distances from the light carrier within a laryngoscope. Comparisons were made between two light sources and carriers. Results Maximal tissue heating using a newer-model light source and new carrier was 16.7°F immediately beneath the light carrier tip and 19.8°F at 1 cm distal to the carrier tip. Other combinations of an older source and carriers failed to raise temperatures. Heating up to 10.7°F occurred with the new source and an older carrier. Conclusion and Significance Tissue heating may occur from contact with operative laryngoscopes. This is an important patient safety issue in laryngology.

Epilepsy and other neurological disorders can have profound social, physical and psychological consequences, especially when they begin in childhood. Moreover, seizure episodes may cause fractures, burns, head injuries and oral injuries. This report presents a case history of an adolescent with a severe tongue injury related to epileptic seizures and outlines the proposed treat-ment, which included use of a maxillary silicone bite guard that allowed healing of the tongue injury within a few months.

We report a healthy teenager with involuntary nocturnal tongue biting resulting in recurrent tongue injury. Causes for tongue biting during sleep in children include seizures, bruxism, faciomandibular myoclonia, hypnic myoclonia, and rarely geniospasm, which has been described as a rare inherited movement disorder accompanied with chin quivering. In the absence of family history, we diagnosed our patient with sporadic geniospasm based on polysomnographic findings with good response to clonazepam. Geniospasm should be considered in the differential diagnosis of cases with unexplained tongue injury in sleep.

This clinical report describes the treatment of a patient having traumatic macroglossia due to schwannoma in the craniocervical region. Enlarged tongue or macroglossia may compromise vital functions of the patient. To avoid a chronic tongue bite trauma, a bite guard that was inspired from a habit breaker was fabricated. Tongue injury has significantly healed with the use of this appliance, and the patient was able to masticate without biting on his tongue.

This clinical report describes the treatment of a 48-year-old patient who demonstrated neuropathologic and reflex mastication of her tongue after an intracerebral hemorrhage. Standard medical interventions failed to address the oral condition, and the attending neurosurgeon consulted the dental team. A provisional soft occlusal guard was initially placed, followed by fabrication of a heat-polymerized, acrylic resin occlusal guard. The tongue injury improved after placement of the oral device and administration of systemic hydrocortisone.

A patient with posttraumatic macroglossia has been presented. A literature review reveals that this is a rare sequela of tongue injury and is usually of acute onset. The delayed symptom of swelling in this patient and the exacerbation of swelling in association with hyaluronidase suggest a causal relationship between the two events. Macroglossia has not been reported in association with hyaluronidase injection, and it is recommended that the drug not be used to treat swelling after tongue injury.