Section II. ABNORMALITIES OF THE TONGUE
The tongue may be affected by most oral soft tissue lesions, but certain lesions
are peculiar to the tongue. These lesions may be the result of developmental
anomalies, systemic disorders, local irritations, or neoplastic changes. Because of the
tendency for oral cancer to occur in the tongue, a thorough examination must be made
to ensure early discovery of these lesions.
MEDIAN RHOMBOID GLOSSITIS
Median rhomboid glossitis (figure 2-9) appears as a smooth, flat, depressed or
elevated nodular area on the dorsum of the tongue just anterior to the circumvallate
papillae. It is usually an oval or diamond-shaped area and stands out because the area
has no filiform papilla. Median rhomboid glossitis is believed to be caused by a Candida
infection, often with secondary hyperplasia. Treatment may include the use of an
antifungal drug and surgical removal of the hyperplastic tissue.
Figure 2-9. Median rhomboid glossitis.
2-10. DEVELOPMENTAL ANOMALIES
a. Cleft or Bifid Tongue. This condition is characterized by the failure of the
two halves of the tongue to unite. It rarely occurs. The cleft tongue is usually normal in
size, but its function is greatly impaired. Treatment is surgical, if indicated.