Surgical Anatomy of the Oral Tongue

  • The oral tongue:
    • Is the freely mobile anterior two-thirds of the tongue
  • The oral tongue is demarcated from the base of tongue by:
    • The circumvallate papillae posteriorly
  • The tongue may be subdivided into:
    • The tip, dorsum, lateral borders and ventral surface
  • The ventral and lateral surfaces:
    • Are in continuity with the floor of mouth:
      • Having a lining mucosa with nonkeratinizing stratified squamous epithelium
  • The dorsum and tip of tongue:
    • Are lined by specialized gustatory mucosa:
      • With a thick, primarily keratinized epithelium
  • The mucosa of the tongue:
    • Overlies the intrinsic muscles of the tongue, in addition to the four paired extrinsic muscles of the tongue:
      • Genioglossus
      • Hyoglossus
      • Styloglossus
      • Palatoglossus
  • Motor innervation to muscles of the tongue:
    • Is via the hypoglossal nerve, except palatoglossus:
      • Which is supplied by the vagus nerve
  • Sensation of the tongue is supplied by the lingual nerve:
    • A branch of the mandibular division of the trigeminal nerve
  • Taste sensation of the oral tongue:
    • Is supplied by fibers of the facial nerve that run with the lingual nerve before passing to the chorda tympanic branch of the facial nerve
  • Lymphatic drainage of the lateral borders of the tongue:
    • Is to the ipsilateral cervical nodes
  • Drainage of the midline, tip and base of tongue:
    • Occurs bilaterally
  • The blood supply to the tongue:
    • Is provided by the paired lingual arteries:
      • The third branches of the external carotid artery
  • During resection of posterior tongue lesions:
    • The contralateral vascular pedicle should be preserved if the tongue tip is to be maintained
  • The tongue is a complex structure with an important role in:
  • Mastication, deglutition and speech
#Arrangoiz #CancerSurgeon #MountSinaiMedicalCenter

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