Tongue Exam

Aka: Tongue Exam, Tongue Disease, Tongue Disorder

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II. Symptoms

  1. Tongue Enlargement (Macroglossia)
  2. Tongue Pain or Tongue Burning
  3. Burning Mouth Syndrome

III. Exam

  1. Stick out Tongue, turn to both sides (CN XII)
  2. Tongue dorsum should be pink, velvety
  3. Use gauze to grasp anterior Tongue to see all surfaces
  4. Palpate for Tongue Masses or Nodules (especially Tongue base and lateral margins)
  5. Observe for white lesions suggestive of Leukoplakia

IV. Causes: Common Benign Findings Requiring NO Treatment

  1. Fissued Tongue (Scrotal Tongue)
  2. Indented Lateral Margins of Tongue
  3. Geographic Tongue (Benign Migratory Glossitis)
  4. Median Rhomboid Glossitis
  5. Varicose Veins of Tongue ("Caviar Lesions")

V. Causes: TongueSurface Disorders

  1. Smooth Tongue (Atrophic Glossitis)
  2. Black Hairy Tongue
  3. Oral Hairy Leukoplakia
  4. Cranial Nerve 12 Paralysis
  5. Lichen Planus
  6. Leukoplakia

VI. Causes: Tongue Growths

  1. See Tongue Mass
  2. Smooth Reactive Lesions
    1. Pyogenic Granuloma
    2. Irritation Fibroma
    3. Lingual Thyroid
  3. Smooth Salivary Gland Lesions
    1. Mucocele
    2. Ranula
    3. Neoplasm (e.g. Pleomorphic adenoma, Mucoepidermoid Carcinoma, Adenoid Cystic Carcinoma)
  4. Smooth Mesenchymal Lesions
    1. Neurofibroma
    2. Schwannoma
    3. Lymphoma
  5. Rough Tumors
    1. Tongue Squamous Cell Carcinoma
    2. Oral Squamous Papilloma (HPV 6, 11)

VII. References

  1. Straub (2024) Am Fam Physician 110(5): 467-75 [PubMed]

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