A Rare Surgical Emergency: Lingual Abscess

Akın, Vural; Sivrice, Mehmet Emre

doi:10.24179/kbbbbc.2020-75603

Cited by 3 publications

(5 citation statements)

References 7 publications

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“…Laboratory tests are an imperative assessment when an abscess is suspected, but it is worth stressing that these can be delayed when a malignancy is the primary suspicion. Notwithstanding, in our review, only rarely did patients have a clear leukocytosis with neutrophilic predominance: in the majority of cases in which it was specified, the white blood cell count remained under 12 × 10 9 /L [2,8,13,15,20,22]. Analogously, only a small increase in inflammatory markers was found in many patients [7,16,20].…”

Section: Laboratory Findingsmentioning

confidence: 62%

“…The clinical history also indicated that some patients had immunocompromising features of different severities, including immunosuppressants or immunomodulators, chemotherapy, and diabetes [2,8,15,16].…”

Section: Predisposing Factorsmentioning

confidence: 99%

“…Their management was thus different: in one case, a videolaryngoscope was necessary for intubation, but after surgical drainage, a tracheostomy was deemed unnecessary [16]. In the other case, a tracheostomy under local anesthesia was preventively performed to allow for safe ventilation [15]. The concern for the airway patency led to the execution of a tracheostomy in the other four cases (one was described as emergent) [15,22,29].…”

Section: Managementmentioning

confidence: 99%

“…In the other case, a tracheostomy under local anesthesia was preventively performed to allow for safe ventilation [15]. The concern for the airway patency led to the execution of a tracheostomy in the other four cases (one was described as emergent) [15,22,29]. The particular danger that is intrinsic to a posterior localization is made clear in the report by Schweigert et al [1]: an unsuccessful intubation was attempted and the patient suffered irreversible cardiac arrest due to hypoxia during the tracheostomy.…”

Section: Managementmentioning

confidence: 99%

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Atypical Tongue Abscesses Mimicking Submucosal Malignancies: A Review of the Literature Focusing on Diagnostic Challenges

Rampi,

Tettamanti,

Bertotto

et al. 2023

Cancers

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Tongue abscesses are rare conditions that usually follow mucosal disruption due to mechanical trauma or foreign body impaction. They typically manifest abruptly as a rapidly growing, hard mass or swelling in the context of tongue muscles; the patient frequently complains of pain, difficulties in swallowing or speaking, and fever. Nonetheless, the features of its presentation, together with accurate clinical evaluation, blood tests, and appropriate imaging tests, are usually sufficient to easily discern a tongue abscess from a malignancy. However, in rare cases, they may occur with slowly progressing and subtle symptoms, nuanced objective and laboratory findings, and inconclusive radiological evidence, leading to difficult differential diagnosis with submucosal malignancy. Herein, we review the literature, available on Pubmed, Embase, and Scopus, on publications reporting tongue abscesses, with atypical presentation suggesting an oral tumor. Our review confirms that tongue abscesses may manifest as a slowly growing and moderately painful swelling without purulent discharge and minimal mucosal inflammation; in this case, they may constitute an actual diagnostic challenge with potentially severe impact on correct management. Atypical tongue abscesses must therefore be considered in the differential diagnosis of tongue malignancy with submucosal extension, even when other diagnostic elements suggest a neoplasia; in this case, a deep biopsy under general anesthesia is essential for differential diagnosis, and simultaneous drainage of the necrotic and abscessual material may resolve the condition.

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Section: Laboratory Findingsmentioning

confidence: 62%

Section: Predisposing Factorsmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

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Atypical Tongue Abscesses Mimicking Submucosal Malignancies: A Review of the Literature Focusing on Diagnostic Challenges

Rampi,

Tettamanti,

Bertotto

et al. 2023

Cancers

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“…A systematic search was performed per the PRISMA literature selection process ( Figure 1 ). 2-9,12-75 Two authors (N.M. and Y.M.) independently searched the literature for relevant articles.…”

Section: Methodsmentioning

confidence: 99%

Hazards and Management of Wire Bristle ingestions: A Systematic Review

Miller¹,

Noller²,

León

et al. 2021

Otolaryngol.--head neck surg.

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Objective Inadvertently ingested grill brush bristles can lodge in various locations and lead to a variety of injuries. They can also be difficult to identify and remove. Our primary objective was to perform a systematic review of cases reported in the literature, with analysis of trends in clinical presentation and success of diagnostic modalities and treatment approaches. Data Sources Cases of reported grill brush bristle ingestion reported in PubMed, PubMed Central, and Google Scholar databases through April 30, 2021. Review Methods Databases were searched for the following terms: (“ingestion” OR “injury” OR “barbeque” OR “BBQ” OR “grill” OR “foreign body” OR “brush” AND “wire” OR “bristle”). Data were collected on patient demographics, clinical presentation, and treatment course. Statistical analysis was performed on characteristics with low risk of confounding. Results An overall 57 studies involving 91 patients were included. Grill brush bristles presented most commonly in the upper aerodigestive tract (48/91), followed by the abdomen (26/91) and deep neck (17/91). Computed tomography was the most accurate imaging modality for initial diagnosis, identifying 92.8% of bristles. Less invasive or adjunctive techniques such as endoscopy, intraoperative imaging, or minimally invasive surgery may be useful particularly for bristles located in the head and neck given the low rate of success of transoral surgery (66.7%). Conclusion Although this review of retained bristle may be biased toward complex cases, retained grill brush bristles represent an underrecognized and difficult-to-manage hazard. When cases are suspected, clinicians should obtain computed tomography imaging based on presentation and tailor management appropriately.

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