Swelling Under the Tongue: Causes and Treatment Options - Otolaryngology

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Swelling under the tongue, particularly in the sublingual area, can be concerning and uncomfortable, especially when accompanied by a persistent feeling of an obstruction or foreign body sensation. Based on your description, it seems that you have been experiencing this swelling for a month despite taking antibiotics, which typically suggests an infection or inflammation. However, since the swelling has not resolved, it may indicate a different underlying issue.

One potential cause of the swelling you are experiencing could be a sublingual gland issue, such as a blockage or a cyst (sublingual cyst). The sublingual glands are located beneath the tongue and can become obstructed by mucus or salivary stones, leading to swelling and discomfort. If the duct of the gland is blocked, saliva can accumulate, causing a cyst-like formation. This condition may not respond to antibiotics, as it is not necessarily an infection but rather a mechanical blockage.

Another possibility is that the swelling could be due to a condition known as sialadenitis, which is the inflammation of the salivary glands. This condition can occur due to dehydration, reduced saliva flow, or infection. If the swelling is not accompanied by pain or fever, it may be less likely to be an acute infection, but rather a chronic issue.

Given that you have already consulted with an oral specialist who did not find significant issues, it may be beneficial to seek a second opinion, preferably from an oral and maxillofacial surgeon or an ENT specialist. These specialists can provide a more thorough evaluation and may recommend imaging studies, such as an ultrasound or MRI, to assess the glands and surrounding tissues more accurately.

In terms of treatment options, if a cyst or blockage is confirmed, surgical intervention may be necessary to remove the obstruction or cyst. If the swelling is due to inflammation, other treatments may include hydration, warm compresses, and possibly medications to reduce inflammation. Additionally, if there is a concern about the possibility of a more serious condition, further diagnostic tests may be warranted.

It is also important to monitor any changes in symptoms, such as increased swelling, pain, or difficulty swallowing, as these could indicate a worsening condition that requires immediate attention.
In summary, while antibiotics may help with infections, they are not effective for mechanical issues like cysts or blockages. A thorough evaluation by a specialist, possibly including imaging studies, is essential to determine the exact cause of your symptoms and to develop an appropriate treatment plan. If you continue to feel discomfort or have concerns about the swelling, do not hesitate to seek further medical advice. Your health and comfort are paramount, and persistent symptoms should always be investigated thoroughly.