Oral cavity
Paul Ong, Rachel Skittrall in Gastrointestinal Nursing, 2017
This chapter describes the embryonic development and gross anatomy of the oral cavity, tongue, teeth and salivary glands. It discusses neurological and endocrine control of mechanical and chemical digestion within the oral cavity. The chapter explains the physiological effects of ageing on the structure and function of the oral cavity, teeth and salivary glands. It focuses on common developmental abnormalities of the oral cavity. The chapter explores the pathogenesis of common disorders of the oral cavity. The palate is divided into the hard palate that forms the roof of the mouth anteriorly and the soft palate posteriorly. Nutrients are ingested into the oral cavity via the mouth. The oral cavity is lined with an oral mucosa of stratified squamous epithelium. The production of saliva is controlled by behavioural, neural, physical and chemical stimuli. Chemoreceptors in the mucosa of the oral cavity are stimulated by irritants, acids, spices and chemicals from food.
Mouth, tongue, lips and ears
Richard Ashton, Barbara Leppard in Differential Diagnosis in Dermatology, 2021
Erythema multiforme involving the mouth presents with multiple irregular erosions on the buccal mucosa. Extensive involvement of the mouth, lips, conjunctiva and genitalia is called Stevens-Johnson syndrome. Most primary infections with the herpes simplex virus occur in early childhood and are asymptomatic with only a few vesicles/erosions on the hard palate or buccal mucosa. Deep groves in the tongue may be a congenital abnormality or seen together with facial nerve palsy and swelling of the lips in the Melkersson-Rosenthal syndrome. Allergic contact dermatitis on the ears presents with an acute eczema. If there are extensive skin lesions as well as extensive mucosal involvement, the patient may need nursing in a burns unit where there are facilities to prevent ulceration of the skin. Aphthous ulcers may rarely be associated with Crohn's disease, ulcerative colitis or coeliac disease.
Case 105
Vincent J Palusci, Dena Nazer, Patricia O Brennan in Diagnosis of Non-accidental Injury, 2015
A 3-month-old baby girl was brought to the emergency department by her parents with a history of spitting up blood. Medical staff noticed some marks on her face and left eyelid. Her parents reported no history of trauma. Images 105a through 105d depict her face and the inside of her mouth. What do the images show? What tests and imaging studies are important to further assess this infant? 240 Image 105a shows an abrasion of her left hard palate at the junction with the soft palate. Image 105b shows bruises on the infant’s left side of her face and left upper eyelid. Image 105c shows a subconjunctival haemorrhage of her right eye and Image 105d shows further bruises on the right side of her face. On further questioning, her father stated he is not able to handle the baby’s crying. He added that when she cries, he wraps his finger with a towel and inserts it into her mouth to make her stop crying, which could explain the palatal abrasion. There was no explanation given by either parent for the facial bruises. However, based on their shape and location along with the history, they could be sustained when holding the baby’s jaw forcefully by the father to insert his finger in her mouth. It is important to determine whether the bruises in children resulted from abuse or an accident. Medical assessment starts with a thorough history and a complete physical examination with documentation of findings. 1 When child abuse is suspected, a report needs to be made to Child Protective Services to prevent further abuse and possibly death. ‘Those who don’t cruise rarely bruise’. 2 Bruises on the face and inside the mouth are particularly concerning for child abuse. Although the bruises were partially explained by the father’s actions, those actions are abusive in nature. To evaluate for associated injuries, she had blood drawn for a complete blood count, liver enzymes, prothrombin time (PT), partial thromboplastin time (PTT), all of which came back normal. She had skeletal survey x-rays, which showed multiple posterior rib fractures and metaphyseal corner lesions, both of which are highly specific for child abuse. Her head magnetic resonance imaging (MRI) scan was normal. A report to Child Protective Services was made based on the diagnosis of physical abuse and the infant was placed with her grandparents.
The Design of Non-Occlusal Intraoral Appliances on Hard Palate and Their Effect on Masseter Muscle Activity During Sleep
Published in CRANIO®, 2007
Koichi Hasegawa, Makoto Okamoto, Goro Nishigawa, Kazuhiro Oki, Shogo Minagi
This study aimed to reveal whether masseter muscle activity during sleep is affected by the difference in design of non-occlusal intraoral appliances on hard palate. Eight healthy Japanese participants were selected and wore each of the four types of appliances (horse shoe, thin, thick and medium thick) during sleep for one week with a one week interval without appliance during sleep. A masseter muscle electromyograph (EMG) was recorded during sleep. The EMG activities were analyzed by calculating the number of bursts per hour, episodes per hour, and bursts per episode. The EMG parameters with the thick type appliance were significantly lower than the baseline condition without appliance. In this study, it is suggested that a thick type appliance has an active effect on suppression of masseter muscle activity.
Giant cell granuloma: Report of a rare location in the hard palate and review of the literature
Published in Acta Oto-Laryngologica Case Reports, 2017
Nadim Khoueir, Rachad Mhawej, Claude Ghorra, Amine Haddad
Giant cell granulomas (GCG) are rare tumors affecting the head and neck region and other sites of the body. Their occurrence in the hard palate is highly uncommon. We present the case of a 15-year-old female patient who presented with a hard palate mass that was confirmed to be a GCG following surgical excision. A review of all cases of GCG in the hard palate reported in the literature till date is presented with an update on differential diagnosis and treatment modalities.
Indolent non-Hodgkin lymphoma primarily involving the hard palate: outcome following radiotherapy
Published in Leukemia & Lymphoma, 2013
Sarah A. Milgrom, Joachim Yahalom
The aim of this study was to report the clinical and pathological characteristics, treatment strategies and outcome in patients with indolent non-Hodgkin lymphoma (NHL) primarily involving the hard palate. Nine consecutive patients with indolent NHL of the hard palate were identified. The palate was a site of initial disease for six patients (four stage IAE and two stage IIIAE) and of relapse for three. There were four cases of grade 1–2 follicular lymphoma (FL), two of mantle cell lymphoma (MCL) and three of marginal zone lymphoma (MZL). All nine patients received involved site radiation therapy (RT) alone. There was no grade ≥ 3 toxicity. At a median follow-up of 55 months, 5-year freedom from local progression was 100%, disease-free survival was 38% and overall survival was 80%. In conclusion, involved site RT is well tolerated and provides excellent local control in the management of indolent lymphoma of the hard palate.