J Korean Assoc Oral Maxillofac Surg.  2021 Oct;47(5):394-397. 10.5125/jkaoms.2021.47.5.394.

Acquired synechia of the tongue to the mouth floor

• Sodnom-Ish B
• Nguyen TTH
• Eo MY
• Cho YJ
• Kim SM
• Lee JH

• KMID: 2521797
• DOI: http://doi.org/10.5125/jkaoms.2021.47.5.394

Abstract

Sodium hydroxide or caustic soda is a corrosive agent that can cause extensive damage to the oral mucosa, lips, and tongue when ingested either accidentally or intentionally. These injuries include microstomia, shallow vestibule, ankyloglossia, speech impairment, loss of teeth and impairment in facial expression. In the present article, we report a unique case of tongue adhesion to the mouth floor and its surgical management in a 66-year-old female patient, who had a history of caustic soda ingestion.

Keyword

Caustic soda; Mouth abnormalities; Tongue synechia; Suicide; Skin transplantation

Figure

• 

  Fig. 1 A, B. A 66-year-old female patient exhibited tongue synechia that completely adhered the tongue to oral floor and restricted tongue movement. C. Preoperative Water’s view showing a radiopaque sialolith in the lower incisor region (marked with arrowheads). D, E. Computed tomography (axial and coronal view) showing a highly attenuated material 8 mm in length at the lower part of the anterior tongue (marked with arrowheads).

• 

  Fig. 2 A. Intra-operative view of the surgical site where the sialolith was identified and removed from the obstructed Wharton’s duct. B. A barrier was made from anterolateral thigh split-thickness skin graft and sutured in place with a bolster dressing. Then a plate splint was fixated using microscrews. C. Postoperative panoramic view of the patient following the surgery.

• 

  Fig. 3 A, B. The patient exhibited uneventful healing after one week and no morbidity associated with the anterolateral thigh split-thickness skin graft (STSG) donor site. C, D. Intraoral view of the patient five years after the surgical release and anterolateral thigh STSG barrier were carried out. E. A panoramic view of the patient after installation of #36, #46 implant fixtures.

Reference

References

1. Contini S, Scarpignato C. 2013; Caustic injury of the upper gastrointestinal tract: a comprehensive review. World J Gastroenterol. 19:3918–30. https://doi.org/10.3748/wjg.v19.i25.3918 . DOI: 10.3748/wjg.v19.i25.3918. PMID: 23840136. PMCID: PMC3703178.

2. Varkey P, Tan NC, Chen HC. 2006; Corrosive injury of oral cavity--a rare presentation. J Plast Reconstr Aesthet Surg. 59:1110–3. https://doi.org/10.1016/j.bjps.2006.03.069 . DOI: 10.1016/j.bjps.2006.03.069. PMID: 16996438.

3. Gupta SK, Rana AS, Gupta D, Jain G, Kalra P. 2011; Unusual presentation of caustic ingestion and its surgical treatment: a case report. J Maxillofac Oral Surg. 10:74–6. https://doi.org/10.1007/s12663-010-0092-x . DOI: 10.1007/s12663-010-0092-x. PMID: 22379326. PMCID: PMC3177500.

4. Chidzonga MM. 2021; Microstomia following caustic soda ingestion: report of a case. J Maxillofac Oral Surg. 20:230–3. https://doi.org/10.1007/s12663-019-01247-4 . DOI: 10.1007/s12663-019-01247-4. PMID: 33927490. PMCID: PMC8042083.

5. Lupa M, Magne J, Guarisco JL, Amedee R. 2009; Update on the diagnosis and treatment of caustic ingestion. Ochsner J. 9:54–9. PMID: 21603414. PMCID: PMC3096249.

6. Ramasamy K, Gumaste VV. 2003; Corrosive ingestion in adults. J Clin Gastroenterol. 37:119–24. https://doi.org/10.1097/00004836-200308000-00005 . DOI: 10.1097/00004836-200308000-00005. PMID: 12869880.

7. Ichioka S, Nakatsuka T, Minegishi Y, Asato H, Takato T, Harii K. 2000; Microsurgical reconstruction for caustic injuries of the oral cavity and esophagus. J Reconstr Microsurg. 16:357–61. https://doi.org/10.1055/s-2000-7345 . DOI: 10.1055/s-2000-7345. PMID: 10954316.

8. Mamede RC, de Mello Filho FV. 2001; Ingestion of caustic substances and its complications. Sao Paulo Med J. 119:10–5. https://doi.org/10.1590/s1516-31802001000100004 . DOI: 10.1590/s1516-31802001000100004. PMID: 11175619.

9. Ryan F, Witherow H, Mirza J, Ayliffe P. 2006; The oral implications of caustic soda ingestion in children. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 101:29–34. https://doi.org/10.1016/j.tripleo.2005.04.025 . DOI: 10.1016/j.tripleo.2005.04.025. PMID: 16360605.