MINORS MANUAL
Tongue injuries are usually the result of direct trauma, such as accidental bites, falls, or injuries from sharp objects. Due to the rich blood supply to the tongue, these wounds can bleed heavily but have a high potential for healing. Injuries can range from superficial cuts to deep lacerations involving the muscle.
Diagnosis
Diagnosis is based on clinical inspection, assessing the extent, location, and depth of the injury. It is essential to check whether the wound affects tongue mobility, involves nearby structures (such as the frenulum or gums), and if there are signs of foreign bodies. The motor and sensory function of the tongue should also be evaluated to rule out nerve damage.
Differential Diagnosis
Pathology | Key Characteristics |
|---|---|
Simple laceration | Superficial cuts, no loss of motor or sensory function |
Tongue bite | Irregular margins, often on the lateral edges |
Lingual haematoma | Swelling, pain, bruising, no visible cut |
Oral ulcers | Painful lesions, no history of acute trauma |
Emergency Management
Haemorrhage control: Apply direct pressure with sterile gauze or, if necessary, use sutures to stop bleeding in deep lacerations.
Wound cleaning: Irrigate with sterile saline to remove food particles and reduce the risk of infection.
Depth assessment: Minor lacerations usually heal on their own, but wounds that penetrate the full thickness of the tongue or involve more than 1/3 of its surface may require suturing.
Suturing: For deep wounds or those affecting tongue mobility, absorbable sutures are recommended. Small, non-penetrating lacerations usually do not require closure.
Antibiotics: Consider antibiotics for contaminated wounds or patients at high risk of infection.
Pain relief: Administer non-steroidal analgesics such as ibuprofen or paracetamol to alleviate pain.
Definitive Treatment
Most tongue injuries heal quickly without surgical intervention. However, extensive lacerations, or those affecting the functionality or aesthetics of the tongue, may require careful suturing. In exceptional cases involving significant tissue loss or complex injuries, a maxillofacial surgeon may be needed to restore function.
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