Developmental Anomalies of the Tongue
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👶 Developmental Anomalies of the Tongue
Congenital anomalies of the tongue arise due to aberrations in its developmental process.
These anomalies can affect both form and function of the tongue and have important clinical implications.
In this post, we will cover six key anomalies:
1. 🛑 Aglossia
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Definition: Complete absence of the tongue.
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Developmental cause:
- Failure of development of:
- Lateral lingual swellings
- Tuberculum impar
- Hypobranchial eminence
- Failure of development of:
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Clinical implication: Rare; severely impairs speech and swallowing.
2. ➗ Hemiglossia
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Definition: Absence of one half of the anterior two-thirds of the tongue.
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Developmental cause:
- Non-appearance of lingual swelling on one side.
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Clinical implication: Asymmetrical tongue; may affect speech and mastication.
3. 🧠 Lingual Thyroid
📌 Important for clinical cases and PG entrance questions.
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Definition: Presence of thyroid tissue within the substance of the tongue.
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Developmental cause:
- Failure of median thyroid rudiment to migrate caudally.
- Rudiment persists at the site of origin in the tongue.
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Clinical implication:
- May present as a midline mass at the base of the tongue.
- Needs to be differentiated from other swellings before biopsy or surgery.
4. 💧 Thyroglossal Cyst
📌 Frequently asked as a short note in exams.
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Definition: Midline cystic swelling due to remnant of the thyroglossal duct.
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Developmental cause:
- Persistence of any part of the thyroglossal duct tract, from tongue to thyroid gland.
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Clinical implication:
- Common congenital neck mass.
- Moves with swallowing or tongue protrusion.
5. 👅 Ankyloglossia (Tongue Tie)
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Definition: Abnormally short frenulum linguae.
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Developmental cause:
- Incomplete regression of the frenulum during development.
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Clinical implication:
- May cause speech difficulty.
- Can interfere with breastfeeding in infants.
6. ✂️ Bifid Tongue
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Definition: Split or cleft in the tip of the tongue (appears as two tips).
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Developmental cause:
- Failure of fusion between:
- Lateral lingual swellings
- Tuberculum impar
- Failure of fusion between:
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Clinical implication:
- Rare condition.
- May be associated with syndromes or midline facial defects.
🧠 Summary Table
| Anomaly | Key Feature | Developmental Cause |
|---|---|---|
| Aglossia | Absence of tongue | Failure of development of all swellings (lateral, tuberculum, hypobranchial eminence) |
| Hemiglossia | One half of anterior tongue absent | Non-appearance of lingual swelling on one side |
| Lingual Thyroid | Thyroid tissue in tongue | Median thyroid rudiment fails to migrate |
| Thyroglossal Cyst | Midline neck cyst | Persistence of thyroglossal duct |
| Ankyloglossia | Tongue tie due to short frenulum | Incomplete regression of frenulum |
| Bifid Tongue | Split tongue tip | Failure of fusion of lateral & median swellings |
📌 Topics like Lingual Thyroid and Thyroglossal Cyst will be discussed in more detail in separate dedicated posts.
📝 All the topics and questions mentioned in this post are explained in detail in my ENT notes - built for exam success and clinical understanding. Get full access by purchasing the notes.