Related Experiment Video
Updated: Aug 9, 2025
Surgical Treatment of an Endolymphatic Sac Tumor
Published on: May 26, 2023
Surgically treated pediatric tongue masses: A 20 Year review
James A Leonard1, Daniel L Blumenthal1, Nancy M Bauman2
1MedStar Georgetown University Hospital, Department of Otolaryngology-Head & Neck Surgery, Washington, DC, USA.
Insights
Surgically managed pediatric tongue lesions are diverse. Infants, larger lesions, and laser treatments increase recurrence risk. Base of tongue lesions pose airway and feeding challenges.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Pathology
Background:
- Pediatric tongue lesions are rare and varied, encompassing congenital malformations, inflammatory conditions, and tumors.
- Surgical management is often necessary for diagnosis and treatment of these diverse pathologies.
Purpose of the Study:
- To present the largest series to date of pediatric tongue lesions treated surgically.
- To analyze patient demographics, presenting symptoms, surgical details, and recurrence rates.
Main Methods:
- Retrospective review of 159 pediatric patients with surgically treated tongue lesions from 1997-2019.
- Evaluation of patient demographics, symptoms, surgical techniques, pathology, and recurrence.
- Statistical analysis using Chi-square, Fisher's exact test, and logistic regression.
Main Results:
- 159 patients were analyzed, with even age distribution across infants and children.
- Common symptoms included pain, difficulty with oral intake, bleeding, and respiratory distress.
- Base of tongue lesions correlated with respiratory distress/oral intake issues (p < 0.001).
- Recurrence risk was higher for lesions managed in infancy (OR 3.85), >2cm (OR 3.45), or treated with laser (OR 4.52).
Conclusions:
- Pediatric tongue lesions present with diverse symptoms requiring careful management.
- Base of tongue lesions necessitate cautious handling due to airway and feeding implications.
- Infancy management and larger lesion size are associated with increased recurrence risk.
Objective:
Pediatric tongue lesions represent a rare, diverse group of pathologies related to congenital malformations, inflammatory changes, and neoplastic masses. We present the largest-to-date series of pediatric tongue lesions managed surgically.
Setting:
Charts of all pediatric patients with a tongue lesion surgically treated at a regional children's hospital from February 1st, 1997 to August 30th, 2019 were reviewed.
Methods:
After obtaining institutional review board approval, a retrospective review was completed of all pediatric patients with a tongue lesion surgically treated at a regional children's hospital from February 1st, 1997 through August 30th, 2019. Charts were evaluated for patient demographics as well as symptoms at presentation, surgical details, pathologic evaluation of the lesion, and rates of recurrence. Categorical variables were compared between various groups using Chi-square and/or Fisher's exact tests. Univariate and multivariable logistic regression analysis was performed unadjusted and adjusted to further explore these relationships.
Results:
159 patients were included in the study with ages distributed relatively even across infants (27.7%), children 1-5 years (27.7%), 6-10 years (23.3%), and greater than 10 years of age (21.4%). Patient/family reported race/ethnic background was most commonly Caucasian (34.8%) or Hispanic/Latino/Spanish Origin (34.0%) followed by Black or African American (21.3%). The most commonly reported symptoms were pain (23.3%), difficulty with oral intake (12.6%), bleeding (11.3%), and respiratory distress (11%). Patients with lesions of the base of tongue were significantly more likely to present with respiratory distress or difficulty with oral intake (p < 0.001). The likelihood of recurrence was observed to be higher with lesions managed in infancy (OR 3.85, CI 1.47-10.0, p = 0.005), those greater than 2 cm (OR 3.45, CI 1.34-8.71, p = 0.009), or with laser (OR 4.52, CI 1.25-15.00), p = 0.015).
Conclusion:
Pediatric patients with tongue lesions may present with a wide array of symptoms. Base of tongue lesions should be managed carefully as they are most likely to create barriers to the airway and oral intake. Larger lesions and those managed in infancy are at increased risk for recurrence.
Related Concept Videos
01:26Assessment of the Mouth
Mouth Inspection
The inspection begins with visually examining the mouth for symmetry, color, and size.
01:26Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
01:21Barrett Esophagus-II: Clinical Manifestations and Management
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...