Glomus Jugulare

E&M

Fig. 4.33 Carcinoma of the tongue. This usually occurs on the margin or from the extension of an ulcer on the floor of the mouth (as shown here). Biopsy of this proliferative ulcer showed squamous cell carcinoma. Partial glossectomy in continuity with a neck dissection, or radiotherapy, are the current treatments.

Syphilitic Leukoplakia

Fig. 4.34 Leukoplakia. This is precarcinomatous on the tongue. It may be secondary to dental or dietary irritation. Leukoplakia is also characteristic of tertiary syphilis, and the tongue is a site where the spirochaete predisposes to carcinoma. Leukoplakia, particularly with no apparent underlying traumatic cause, should be biopsied to exclude carcinoma.

Fig. 4.34 Leukoplakia. This is precarcinomatous on the tongue. It may be secondary to dental or dietary irritation. Leukoplakia is also characteristic of tertiary syphilis, and the tongue is a site where the spirochaete predisposes to carcinoma. Leukoplakia, particularly with no apparent underlying traumatic cause, should be biopsied to exclude carcinoma.

Peperonity Little Slut

Fig. 4.35 Hypoglossal nerve paralysis.

Initially, there is fibrillation and later atrophy of the muscles on one side of the tongue. The tongue deviates on protrusion to the side of the nerve palsy. A destructive lesion in the jugular foramen region may extend to involve the hypoglossal nerve as it emerges from the nearby anterior condylar foramen. This paralysis of the tongue shows wrinkling caused by fibrillation, and is due to a glomus jugulare tumor, which has also damaged the cranial nerves emerging through the jugular foramen (IX, X, and XI).

The hypoglossal nerve, if involved in cervical metastases, may be sectioned in a radical neck dissection (see p. 222).

Glomus Jugulare

■ The Fauces and the Tonsils

Uvulitis From Snoring

Fig. 4.36 The uvula. This obvious anatomical feature in the oropharynx has little pathological significance. When particularly long, however, as here, it has on occasion been thought responsible for various throat symptoms such as discomfort and snoring. Partial amputation has been recommended.

The uvula is excised along with part of the tonsillar fauces and soft palate in the operation of uvulopalatopasty for snoring. The appearance of the palate after operation is seen in Figs. 4.38b and 4.66.

Bifid Uvula

Fig. 4.37 Bifid uvula. A common minor congenital deformity of the palate.

It is of little significance, but it may be associated with a submucous palatal cleft. Inflammation of the uvula as an isolated entity may occur, however, and a cherry-like enlargement may be the sole presenting sign of a sore throat (uvulitis).

Fig. 4.37 Bifid uvula. A common minor congenital deformity of the palate.

It is of little significance, but it may be associated with a submucous palatal cleft. Inflammation of the uvula as an isolated entity may occur, however, and a cherry-like enlargement may be the sole presenting sign of a sore throat (uvulitis).

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