The Oropharynx Mouth and Lips

Small Mucocele Lip

Fig. 4.3 Lip ulcers. Lip ulceration has numerous causes, eithertraumatic, inflammatory, or neoplastic. The provisional diagnosis can be made from the history and type of ulcer. Biopsy is necessary to confirm the diagnosis. This lesion is a pyogenic granuloma. Although these lesions are frequently small and related to trauma, they may enlarge from secondary infection (see Fig. 4.4) and take several weeks to heal.

Fig. 4.1 A mucocele of the lip. Mucoceles are cystic, nontender swellings presenting on the lips or in the oral cavity. They result from extravasation of mucus from a mucous gland into the surrounding tissue. Treatment is excision, which is not always easy because of the extremely thin wall. Simple marsupialisation is often adequate.

Fig. 4.2 A hemangioma of the lip. These may require excision or laser surgery from a cosmetic point of view or on account of bleeding with trauma.

Fig. 4.3 Lip ulcers. Lip ulceration has numerous causes, eithertraumatic, inflammatory, or neoplastic. The provisional diagnosis can be made from the history and type of ulcer. Biopsy is necessary to confirm the diagnosis. This lesion is a pyogenic granuloma. Although these lesions are frequently small and related to trauma, they may enlarge from secondary infection (see Fig. 4.4) and take several weeks to heal.

Biopsy Lip Healing
Fig. 4.5 Herpes simplex of the lip showing the characteristic vesicles (a) which later crust (b).

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Fig. 4.6 Keratosis may extend from the angle of the mouth along the occlusal plane of the teeth and is commonly a dental problem; it may be self-induced due to nervous cheek-biting. It is often the result of persistent trauma to the mucous membrane.

When occurring in a site not exposed to trauma, e.g., the retromolar fossa, it should arouse suspicion that the mucosal change may be malignant and, therefore, a biopsy is necessary.

Plummer Vinson Lips

Fig. 4.7 Angular stomatitis (arrow) occurs with the type of dental hyperkeratosis shown in Fig. 4.6, but it may also be part of the Plummer-Vinson or Patterson-Brown-Kelly syndromes in which glossitis (also seen here) and hypochromic anemia are associated with a postcricoid lesion, either a web or a carcinoma. This syndrome occurs mostly in women.

Fig. 4.7 Angular stomatitis (arrow) occurs with the type of dental hyperkeratosis shown in Fig. 4.6, but it may also be part of the Plummer-Vinson or Patterson-Brown-Kelly syndromes in which glossitis (also seen here) and hypochromic anemia are associated with a postcricoid lesion, either a web or a carcinoma. This syndrome occurs mostly in women.

Paterson Kelly Plummer Vinson Syndrome
Fig. 4.8 The torus palatinus. The bony hard mid-line palatal swelling can be diagnosed confidently by these characteristics (arrow). It is a common finding, and only requires removal if it interferes with the fitting of a denture.
Palatal Swelling Surgery
Fig. 4.9 A large torus palatinus may take on a curious, irregular appearance suspicious of a carcinoma. Similar bony swellings occur on the lingual surface of the lower alveolus opposite the premolars (torus mandibularis).
Torus Mandibularis
Fig. 4.10 Torus mandibularis. A white bony hard lesion arising from the inner aspect of the mandible may present as a swelling in the floor of the mouth (arrow). This is considerably less common than the torus palatinus.
Torus Mandibularis
Fig. 4.11 A bilateral torus mandibularis (arrows).

Fig. 4.12 Ectopic pleomorphic adenoma. A palatal swelling which is not bony and hard may be a fissural cyst if mid-line, but if placed to one side (as it is here), it is almost certainly a tumor of one of the minor salivary glands. Biopsy is necessary. It is frequently a pleomorphic adenoma, but may be an adenoid cystic carcinoma or other malignant salivary tumor. A tumor extension from the maxillary antrum must also be excluded.

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Responses

  • AMALIA
    How long does it take for a bitten lip to heal?
    7 years ago

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