Papillomas in the tongue
The content of the article:
- The reasons
- External manifestations
-
Papilloma on the tongue - what to do?
- Oral cavity sanitation
- General therapy
- Destruction
-
Methods for removing neoplasms on the mucous membrane of the tongue
- Laser exposure
- Electrocoagulation
- Radio wave treatment
- Cryotherapy
- Surgical excision
- Other methods
- Video
Papillomas in the tongue are benign neoplasms that arise from epithelial cells mainly under the influence of the human papillomavirus (HPV).
Most often occur in women over 40 years of age (57%). However, under appropriate circumstances, the disease can manifest itself at any age (the child has a high risk of infection from the mother).
Papillomas in the language according to the classification of A. L. Mashkillyson (1970) is usually referred to as facultative precancerous conditions - the risk of malignancy is up to 10%.
Papillomas in the tongue are caused by permanent trauma to the mucous membrane and / or HPV infection
According to ICD, papilloma refers to squamous cell formations M 80.5-M 80.8. When examining a patient, the doctor relies on a visual examination, and in doubtful cases, a biopsy of the formation is shown (differential diagnosis with a polyp, hemangioma).
The reasons
In most cases, the main cause of papillomas in the tongue is the human papillomavirus. Sometimes the infection can affect several areas at once (papillomas of the tongue and axillary zone or chest, or a combination with anogenital warts), while papillomas can be caused by different strains of the virus.
Depending on the causes of the occurrence, several types of papillomas of the tongue are distinguished.
| View | Features: |
| Traumatic (reactive) | Received as a result of damage to the tongue, often the smallest. The peculiarity is that such formations, as a rule, are single and stop growing as the damaged area heals. This group also includes trauma to the mucous membrane with prostheses, crowns or chipped edges of the teeth. |
| True (neoplastic) |
The classic variant of impaired cell differentiation (precancerous phenomena). The cause of the sudden failure in cell division is not exactly known, but there are a number of predisposing factors: · Constant excessive action of high temperatures (consumption of very hot food, drinks); · Physical and chemical effects (smoking, alcohol); · Hereditary predisposition. |
| Viral |
The main reason for the appearance of papillomas is papillomavirus infection. The contact-household transmission path is implemented in the following ways: · Common household items with a sick or potentially infected person (dishes, towels); · Kisses with the carrier of the virus; · Oral-genital sexual contacts. HPV is a thermostable DNA virus that is relatively stable in the external environment. The division of the viral particle begins after its penetration into the basal layer of the epithelium. |
The following circumstances predispose to the development of the disease:
- Decreased immunity against the background of frequent infectious diseases of a viral or bacterial nature.
- Diseases that have a long chronic course.
- Disruption of the normal immune response in HIV-infected patients. In particular, the appearance of papillomas in the oral cavity is often regarded as one of the first markers of HIV infection.
- Hormonal imbalance and disruption of normal metabolic processes in tissues (reduces the barrier functions of the skin and mucous membranes).
- Stress, chronic fatigue and bad habits, especially smoking. In this case, the strength of the immune response to the action of the viral agent is reduced.
- Taking certain medications (contraceptive, antibacterial, cytostatic). As a result of prolonged use, the normal microflora of the oral cavity is disrupted, which reduces local immunity.
- Diseases of the gastrointestinal tract (diarrhea of any genesis, for example). At the same time, conditionally pathogenic or pathogenic flora also begins to dominate in the intestine (later this affects the oral cavity as well).
- Violation of the normal diet (the predominance of animal fats, insufficient intake of plant foods). All this leads to a change in the microflora of the oral cavity.
Special risk groups for the development of this disease are the elderly, pregnant women and children due to the peculiarities of the immune system.
External manifestations
External (pictured) neoplasms look different depending on the specific form. The table shows general manifestations regardless of the specific origin of the pathology (viral, traumatic, neoplastic) due to the extreme similarity between them.
| View | Manifestations |
| Pointed |
· Significantly protrude above the skin surface; · More often multiple; · Have a bumpy surface; Are on a thin stalk, hanging over the surface of the tongue; · The color does not differ from the surrounding tissues (it can rarely be lighter or darker, depending on the concentration of blood vessels); Localized, as a rule, along the edge or at the tip of the tongue (have the greatest risk of injury); • soft elastic, painless on palpation. |
| Flat |
· They have a wide base and slightly protrude above the skin (type of warts); · Diameter up to 2 cm; · More often multiple, although there are also single; Whitish with a smooth surface (less often they will have an intense color); · Are sharply delimited from the surrounding tissues; · Spherical or oval. On palpation, they are soft-elastic, painless. |
There is also a division into non-keratinizing (pale pink and soft consistency) and keratinizing papillomas (white and denser texture). Often there is a weak corolla of inflammation around the formation.
Both types of formations grow slowly, however, there are a number of alarming symptoms indicating a possible rebirth:
- discomfort when eating;
- bleeding (directly into the formation itself with a change in its color or into the oral cavity);
- an increase in regional lymph nodes;
- ulceration;
- rapid growth and discoloration;
- the disappearance of clear boundaries and the tendency to merge;
- strengthening of the process of keratinization and, as a consequence, the compaction of education.
Papilloma on the tongue - what to do?
Oral cavity sanitation
Treatment of papillomas in the tongue begins with sanitation of the oral cavity to eliminate a possible source of injury to the mucous membrane and eliminate the risk of a secondary infection. Reorganization consists in the treatment of caries and its complications; this can also include the reinstallation of crowns or dentures, if necessary.
Oral cavity sanitation is the first thing to do when papillomas appear on the tongue
General therapy
There is no specific antiviral therapy, that is, directed specifically at this virus. In some cases, antiherpetic drugs are used due to some similarity in the structure of viruses (drugs Acyclovir, Panavir, Indinol).
Strengthening therapy (immunomodulators, vitamin complexes) are prescribed to strengthen immunity and reduce the likelihood of new neoplasms. For this purpose, Leikin, Cycloferon, Interferon can be used. General measures aimed at strengthening the body's defenses are also important - proper nutrition, a healthy lifestyle, adherence to work and rest.
Destruction
The main role is played by destructive treatment, which is aimed at removing the existing formations in the language, however, it must be understood that this is the elimination of the symptoms of the disease, which does not affect its causes.
Methods for removing neoplasms on the mucous membrane of the tongue
Laser exposure
The most effective method due to the selectivity of the burnt tissue. Modern devices are easily tuned exclusively for neoplasm with minimal uptake of healthy cells. The risk of complications after the procedure is less than 1%. The laser is aimed at the formation and the optimal program is selected (specific wavelength, time and depth of exposure) depending on the type of build-up. There are both automatic programs with fixed values and a number of adjustable parameters for atypical forms of papillomas. The tissues are burned out layer by layer; in case of pointed forms, the formation is cut off at the very base. Formations of different localization are available for removal, including in the area of the frenum and root.
Electrocoagulation
The method is based on the removal of the build-up using an electric knife. The method is less effective than the previous one, since there is significant injury to the surrounding tissues. The clinical manifestations of a burn do not occur immediately, but over several days, since not only nearby cells, but also cells of healthy tissues located at some distance, suffer from overheating. At the site of the removed formation, a wound surface appears, which must be treated with antiseptics to avoid infection. The fabrics are burned out in layers, the exposure time is on average 20-60 seconds. Electrocoagulation is used mainly for single papillomas localized on the tip or lateral surfaces of the tongue.
Radio wave treatment
A low-traumatic method that allows you to remove several formations at once (important for papillomatosis). The method is based on exposure to a radio frequency wave, which leads to heating and destruction of the cells of formation. The exposure time is selected individually.
Cryotherapy
In this anatomical region, it is used less often than other methods due to the capture of a large amount of tissue. After use, a chemical burn is formed at the site of formation, which heals for a long time (about 14 days), which increases the risk of a secondary infection. They are used more often in formations with a large area. The active ingredient is liquid nitrogen. Exposure time from 10 to 50 sec.
Surgical excision
The method consists in removing neoplasms with a scalpel. They are rarely used due to the high trauma, the inability to remove a large number of formations at once and the additional risk of contamination in the case of viral papillomas. Usually, surgical removal is resorted to in case of localization in the area of the root of the tongue or in case of suspicious neoplasms for further cytological and histological examination. It is performed under local anesthesia. In some cases, after excision, sutures are applied for additional hemostasis. Dressings are shown until the wound is completely healed.
Other methods
The use of ointments or gels for local treatment of papillomas of this anatomical region is not only ineffective, but also associated with a high risk of chemical burns of the tongue and mouth.
Sometimes, subject to approval by the attending physician, it is allowed to treat formations with home methods. As a rule, home treatment acts as an adjunct to the main therapy.
Several recipes as an example:
- Pour 2-3 tbsp. l. celandine and 1 tbsp. l chamomile 300 ml of water. Bring to a boil, leave for 1-2 hours. Rinse your mouth 3-4 times a day for 14 days.
- Mix equal proportions of calendula, chamomile and mint. Pour 150 ml of water, boil, cool, strain. Rinse your mouth with broth for 2 weeks.
Video
We offer for viewing a video on the topic of the article.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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