The tongue is a rather peculiar piece of tissue, when you
really contemplate it, particularly compared to other organs in the body. The shape of the eye and ear makes logical sense
to capture all that visual and auditory stimuli around you; the stomach is designed
like a bag to hold all that tasty food and beer you’ve engorged; and the lungs
act as thin bellows pumping air in and out.
The architecture of these organs makes sense. So what’s with the tongue? Is there a rhyme and reason for its design or
is this another example of God’s sense of humor?
Speaking of which, many ENT doctors exercise a disturbingly
warped sense of humor, having to do with a certain eccentricity that makes us either
endearing or downright scary to our patients.
I’m not entirely immune to this phenomenon, so I was told. I’ve had little kids cry at the first site of
me while others talk to me like I was their best friend. So when it comes to amusing aspects of the
tongue, I tend to bite my own when patients present after discovering certain tongue-findings
that are normal but send them through the roof, colloquially speaking. Sometimes these are bona fide findings of
concern; other times these are normal structures they’ve not noticed before. Following are several of the features of the
tongue that are actually normal anatomical features.
As such, this is not meant to be an exhaustive source of
tongue anatomy and abnormalities, but as a concise bit of information. As always if you have doubts, please see hour
doctor. And please don’t send me or
another doctor a “selfie” of your tongue since that would be--politely
speaking--just plain weird.
Circumvallate papillae
If you happen to stick your tongue way out and look deep
towards your throat, you may notice several raised, pink bumps far back on the
tongue. Fear not for these are normal
structures that dot the back-side of the tongue named the circumvallate
papillae (“papilla” is one of these bumps; “papillae” = more than one). They form a boundary of what we docs call the
“base of the tongue.” I’ve had a few
people present in a panic—a few doctors included—when they happened to notice
these guys in the mirror, fearing the worse: an unnatural growth or tumor, or
perhaps a communicable disease they acquired from a long-lost flame whom they
later discovered wasn’t as innocent or chaste as they were lead to believe. For the most part be reassured that--in
Arnold Schwarzenegger-like fashion--“it’s not a too-mah.” These usually go unnoticed since not many
people painstakingly look deep into their mouths in the mirror.
Wharton’s ducts
If you look towards the bottom of the tongue, or the ventral
part of the tongue as we docs call it, you’ll see a few interesting features. Two of these guys are small pumps on each side
of the frenulum (see below). Not to fear these two little dudes since
they’re the openings to “Wharton’s ducts.”
A duct is simply a tube which, in this case, connects the submandibular
gland (the gland below your jaw on each side that secretes saliva—ie, “spit”)
to the floor of the mouth where you’ll see those little bumps. These are the ONLY exits of saliva for those
glands, so do us all a favor and don’t allow yourself or someone else to cut
these little guys out, unless of course a trained professional sees something
that’s abnormal—i.e., “not supposed to be there.”
Frenulum
This is the thin line of tissue travelling right down the
middle on of the underside of the tongue.
Sometimes this is an actual band of tissue. The frenulum can be prominent in infants,
sometimes tethering the tongue and restricting its movement. This can cause problems with feeding. If this is the case, the frenulum can be
incised (fancy doctor word for “cut”) to release the tethering affect and
allowing for more normal feeding and suckling.
As you may imagine, a prominent frenulum also can cause problems with
speech, since you need a mobile tongue for talking, and incising it for this
reason is also a good indication, though increasing someone’s ability to talk
may not be entirely desirable for certain folks.
Checking your mouth and throat on a regular basis is
actually a good thing and knowledge of some of the main features of the anatomy
is helpful. Of course, if you see something
that’s concerning or you have any doubts or you’re really freaking out, don’t
hesitate to see your doctor or dentist for a proper evaluation. An ounce of prevention is worth a ton of
gold, as someone wiser than me said.
©Randall S. Fong, M.D.
www.randallfong.com
©Randall S. Fong, M.D.
www.randallfong.com
Comments
Post a Comment