Fissured Tongue

Aka: Fissured Tongue, Dorsal Fissuring of Tongue, Congenital Furrows of Tongue, Scrotal Tongue, Lingua Plicata, Furrowed Tongue

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II. Epidemiology

  1. Prevalence as a normal Tongue variant in 10 to 20% of adults
  2. Inherited Tongue fissuring increases with age

III. Pathophysiology

  1. Normal benign Tongue variation increases with age
  2. May be caused by Xerostomia

IV. Symptoms

  1. Often asymptomatic
  2. Symptoms when they occur are typically related to food trapping in fissures
    1. Halitosis
    2. Altered Tongue coloration

V. Signs

  1. Deep fissures, grooves and folds of Tongue
    1. Deep median sulcus
    2. Deep transverse furrows across Tongue dorsum

VI. Associated Conditions

  1. Down Syndrome
  2. Sjogren Syndrome
  3. Psoriasis
  4. Geographic Tongue
  5. Melkersson-Rosenthal Syndrome (rare)
    1. Triad of Fissured Tongue, relapsing Facial Edema, Facial Nerve Palsy

VII. Differential Diagnosis

  1. Syphilitic Glossitis causes longitudinal Tongue furrows

VIII. Management

  1. Treat underlying causes (esp. Xerostomia)
  2. Removal of trapped debris
    1. Stroke Tongue 15x with Tooth Brush after meals, bedtime
    2. Oral irrigation

IX. Complications

  1. Food debris accumulates in crevices and can irritate

X. See Also

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

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