Papillomas in the tongue are benign neoplasms that arise from epithelial cells mainly under the influence of the human papillomavirus (HPV).

Most common in women over 40 (57%). However, under appropriate circumstances, the disease can manifest itself at any age (the child has a high risk of infection from the mother).

Papillomas in the tongue according to classification A. Mashkilleyson (1970). ) is usually referred to as facultative precancerous conditions - the risk of malignancy is up to 10%.

Papillomas in the tongue are caused by constant trauma to the mucous membrane and / or infection with HPV. According to the ICD, papilloma refers to squamous formations M 80. 5-M 80. When examining a patient, the doctor relies on a visual examination, and in doubtful cases, a biopsy of the formation is indicated (differential diagnosis with a polyp, hemangioma).

Causes In most cases, the main cause of papillomas in the tongue is the human papillomavirus.. Sometimes the infection can affect several areas at once (papillomas of the tongue and axillary zone or chest, or a combination with anogenital warts), while papillomas can be caused by different strains of the virus.

Depending on the causes of occurrence, several types of papillomas of the tongue are distinguished..

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Peculiarities.

Traumatic (reactive).

Obtained as a result of damage to the tongue, often the most minor. The peculiarity lies in the fact that such formations, as a rule, are single and stop growing as the damaged area heals.. Injury to the mucous membrane with prostheses, crowns or chipped edges of the teeth fall into the same group..

True (neoplastic).

The classic variant of impaired cell differentiation (precancerous phenomena). The cause of the sudden failure in cell division is not exactly known, but there are a number of predisposing factors:.

constant excessive exposure to high temperatures (eating very hot food, drinks);

physical and chemical effects (smoking, alcohol);

a hereditary predisposition.

Viral.

The main cause of papillomas is papillomavirus infection.. The contact-household transmission path is implemented in the following ways:.

common household items with a sick or potentially infected person (dishes, towels);

Kissing with a carrier of the virus;

Oral-genital sexual contact.

HPV refers to thermostable DNA-containing viruses, relatively stable in the external environment.. The division of the viral particle begins after its penetration into the basal layer of the epithelium..

Predisposing to the development of the disease are the following circumstances:.

Reduced immunity against the background of frequent infectious diseases of a viral or bacterial nature.

Diseases that have a long chronic course.

Impaired normal immune response in HIV-infected patients. In particular, the appearance of papillomas in the oral cavity is often regarded as one of the first markers of HIV infection..

Hormonal imbalance and disruption of normal metabolic processes in tissues (reduces the barrier functions of the skin and mucous membranes).

Stress, chronic fatigue and bad habits, especially smoking. In this case, the strength of the immune response to the action of the viral agent is reduced..

Taking certain medications (contraceptive, antibacterial, cytostatic). As a result of long-term use, the normal microflora of the oral cavity is disturbed, which reduces local immunity..

Diseases of the gastrointestinal tract (diarrhea of \u200b\u200bany origin, for example). At the same time, opportunistic or pathogenic flora also begins to dominate in the intestines (subsequently this affects the oral cavity)..

Violation of the normal diet (the predominance of animal fats, insufficient intake of plant foods). All this leads to a change in the microflora of the oral cavity..

Special risk groups for the development of this disease are the elderly, pregnant women and children due to the peculiarities of the immune system..

External manifestations External (pictured) neoplasms look different depending on the specific form. The table shows common manifestations, regardless of the specific origin of the pathology (viral, traumatic, neoplastic) due to the extreme similarity between them.

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Manifestations.

pointed.

Protrude significantly above the surface of the skin;

often multiple;

have a bumpy surface;

are on a thin stalk, hang over the surface of the tongue;

the color does not differ from the surrounding tissues (rarely it can be lighter or darker depending on the concentration of the vessels);

localized, as a rule, along the edge or at the tip of the tongue (have the greatest risk of injury);

on palpation soft elastic, painless.

flat.

Have a wide base and slightly protrude above the skin (a type of wart);

diameter up to 2 cm;

More often multiple, although there are also single ones;

whitish with a smooth surface (rarely will have an intense color);

sharply demarcated from surrounding tissues;

spherical or oval shape.

On palpation soft elastic, painless.

There is also a division into non-keratinizing (pale pink in color and soft consistency) and keratinizing papillomas (white color and denser consistency). Often there is a weak halo of inflammation around the formation..

Both types of formations grow slowly, however, there are a number of alarming symptoms indicating a possible rebirth:.

discomfort when eating;

bleeding (directly into the formation itself with a change in its color or into the oral cavity);

enlargement of regional lymph nodes;

ulceration;

rapid growth and color change;

the disappearance of clear boundaries and the tendency to merge;

strengthening of the process of keratinization and, as a result, compaction of the formation.

If the presented signs occur, a thorough diagnosis should be carried out with a number of oncological diseases, which outwardly manifest themselves in the initial stages in almost the same way as typical papillomas.

Papilloma on the tongue - what to do? Sanitation of the oral cavityTreatment of papillomas in the tongue begins with the sanitation of the oral cavity to eliminate a possible source of injury to the mucous membrane and eliminate the risk of secondary infection. Sanitation consists in the treatment of caries and its complications, this also includes the reinstallation of crowns or prostheses, if necessary..

Sanitation of the oral cavity is the first thing to be done when papillomas appear on the tongue. General therapy. Specific antiviral therapy, t. directed specifically at this virus does not exist. In some cases, antiherpetic drugs are used due to some similarity in the structure of viruses (drugs Acyclovir, Panavir, Indinol).

Strengthening therapy (immunomodulators, vitamin complexes) are prescribed to strengthen immunity and reduce the likelihood of new neoplasms. For this purpose, Leykin, Cycloferon, Interferon can be used.. General measures aimed at strengthening the body's defenses are also important - proper nutrition, a healthy lifestyle, compliance with the regime of work and rest..

Destruction The main role is played by destructive treatment, which is aimed at removing existing formations in the tongue, but it must be understood that this is the elimination of the symptoms of the disease, which does not affect its causes.

Methods for removing neoplasms on the mucous membrane of the tongue Laser exposure The most effective method due to the selectivity of the burned tissue. Modern devices are easily tuned exclusively to a neoplasm with minimal capture of healthy cells.. The risk of complications after the procedure is less than 1%. The laser aims accurately at the formation and the optimal program is selected (specific wavelength, time and depth of exposure) depending on the type of build-up. There are both automatic programs with fixed values, and a number of adjustable parameters for atypical forms of papillomas. Fabrics are burned out in layers, with pointed forms, the formation is cut off at the very base. Removal is available for formations of different localization, including in the region of the frenulum and root.

ElectrocoagulationThe method is based on the removal of the build-up using an electric knife. The method is less effective than the previous one, since there is a significant injury to the surrounding tissues. Clinical manifestations of a burn do not occur immediately, but over several days, since not only nearby cells suffer from overheating, but also cells of healthy tissues located at some distance. A wound surface appears at the site of the removed formation, which must be treated with antiseptics to avoid infection. Fabrics are burned out in layers, the exposure time is on average 20-60 seconds.. Electrocoagulation is used mainly for single papillomas localized on the tip or lateral surfaces of the tongue..

Radio wave treatment A low-traumatic method that allows you to remove several formations at once at a time (important for papillomatosis). The method is based on exposure to a radio frequency wave, which leads to heating and destruction of the formation cells.. The exposure time is selected individually.

CryotherapyIn this anatomical region, it is used less frequently than other methods due to the capture of a large number of tissues. After use, a chemical burn is formed at the site of formation, which heals for a long time (about 14 days), which increases the risk of secondary infection. Used more often in formations with a large area. Active ingredient - liquid nitrogen. Exposure time from 10 to 50 sec.

Surgical excisionThe method consists in removing neoplasms with a scalpel. They are rarely used due to high trauma, the inability to remove a large number of formations at once and the additional risk of seeding in the case of viral papillomas. Usually, surgical removal is resorted to in case of localization in the region of the root of the tongue or in case of suspicious neoplasms for further cytological and histological examination.. Performed under local anesthesia. In some cases, after excision, sutures are applied for additional hemostasis.. Dressings are shown until the wound is completely healed.

Other methods The use of ointments or gels for local treatment of papillomas of this anatomical region is not only ineffective, but is also associated with a high risk of chemical burns of the tongue and oral cavity..

Sometimes, subject to the approval of the attending physician, it is allowed to treat formations with home methods.. As a rule, home treatment acts as an auxiliary method that complements the main therapy..

A few example recipes:.

Pour 2-3 tbsp. celandine and 1 tbsp. l chamomile 300 ml water. Bring to a boil, insist 1-2 hours. Rinse your mouth 3-4 times a day for 14 days.

Mix equal proportions of calendula, chamomile and mint. Pour 150 ml of water, boil, cool, strain. Rinse your mouth with decoction for 2 weeks.

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