Tongue Issues: When to Consider Surgery for Growths - Otolaryngology

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When it comes to growths or lesions on the tongue, particularly those that are persistent and cause discomfort or a sensation of something being "stuck," it is essential to approach the situation with caution and thorough evaluation. The presence of a growth at the base of the tongue, especially if it has not resolved with conservative treatment such as topical medications for oral inflammation, warrants further investigation.


Understanding Tongue Growths
Tongue growths can arise from various causes, including benign conditions like fibromas, papillomas, or cysts, as well as more serious conditions such as squamous cell carcinoma. The fact that the growth is not painful is a positive sign, but it does not eliminate the need for further evaluation. The sensation of something being present can be due to irritation or inflammation, which may or may not be related to the growth itself.


When to Consider Surgery
1. Persistence of Symptoms: If the growth has not diminished or resolved after a reasonable period of conservative treatment (like topical medications), it is advisable to consider surgical intervention. Persistent lesions that do not respond to treatment may require biopsy or excision to rule out malignancy.

2. Changes in Appearance: If the growth changes in color, size, or texture, or if new symptoms develop (such as pain, bleeding, or difficulty swallowing), these are red flags that necessitate further evaluation.

3. Duration: Growths that persist for more than two weeks without improvement should be assessed by a specialist, typically an otolaryngologist (ENT specialist) or a dentist with experience in oral pathology.

4. Biopsy Consideration: If there is any suspicion of malignancy, a biopsy may be necessary. This can often be done in an office setting under local anesthesia, allowing for a definitive diagnosis.

5. Patient’s Overall Health: The decision to proceed with surgery also depends on the patient's overall health and any underlying conditions that may complicate surgical intervention.


Surgical Options
If surgery is deemed necessary, the options may include:
- Excisional Biopsy: This involves removing the entire growth for pathological examination. It is often the best approach if there is concern about cancer.


- Incisional Biopsy: If the growth is large or if the patient has other health concerns, a portion of the growth may be removed for analysis.

- Laser Surgery: In some cases, laser surgery may be used to remove growths, especially if they are superficial.


Conclusion
In summary, if the growth at the base of your tongue has not improved with treatment and continues to cause discomfort, it is advisable to seek further evaluation. A consultation with an ENT specialist or an oral surgeon can provide clarity on whether surgical intervention is necessary. They will likely perform a thorough examination, possibly including imaging studies, and may recommend a biopsy to ensure an accurate diagnosis. Early intervention can be crucial, especially if there is any risk of malignancy, so do not hesitate to pursue further medical advice.