Any person in the course of life faced with such a misfortune as a burn. The lesion of the tongue is a serious problem that, in addition to unpleasant and painful sensations, violates many physiological processes: speech, swallowing, eating food. In the structure of appeal for medical care, 70% are children, seeking to explore the world around them in all possible ways. Unfortunately, not everyone knows what to do if you burn your tongue. The tactics of emergency care and further reference directly depends on the causative factor. It is necessary to correctly assess the situation in order to prevent deterioration.
The causes that can lead to a burn of the tongue, as well as other components of the oral cavity are numerous. Home - inattention. The most common are:
- The effect of high temperatures. The reason is the consumption of hot drinks and food, inhalation of steam or hot air (for example, during inhalations or in steam rooms). As a result, there is usually a lesion of the surface layers of the epithelium, followed by rejection.
- The impact of electric current. Most often occurs in violation of the technique of physiotherapy procedures. The burn is projected in the area of an improperly applied electrode. Less common causes are domestic injuries due to non-compliance with electrical safety techniques.
- Influence of ionizing radiation. Patients with oncological hospitals are the main risk group. Radiation therapy aimed at the destruction of deep-seated cancer cells, kills everything in the path of the beam. Systematic exposure causes damage to both the mucous membrane and muscle tissue of the organ.
- Chemical substances. Such a burn can occur during dental care due to the ingress of arsenic paste or various concentrated solutions (used to clean the root canals) through an inadequately applied dressing. Such drugs contain anesthetics, so the clinical manifestations can be only in the long term. The same can be caused by alcohol (over 90 degrees), acids and alkalis entering the oral cavity. Often, due to safety violations, gasoline burns occur. It is possible the erroneous use of hazardous substances.
Types and degrees of burns
The clinical manifestations of different types of burns can vary significantly. The degree of destruction of the tissues of the tongue will depend on the nature of the traumatic factor, the duration of exposure, the state of the mucous membrane of the tongue at the time of contact (damaged or not).
Among the common symptoms can be identified such as:
- Feeling of burning and tearing, discomfort;
- The presence of soft tissue edema (less often, edema extends far beyond the root of the tongue, involving the pharynx and tonsils);
- Hypersalivation (increased salivation);
- Acute deterioration of subjective sensations when using irritating substances (spices, hot food, alcohol, etc.).
- Difficulty in swallowing and speaking due to pain and swelling.
In the development of the disease there are 3 periods:
- Initial or sharp. It is characterized by hyperemia (redness) of the tongue, the development of edema, and the onset of necrotic changes in the surface layers of the mucosa.
- Intermediate. The edema is increasing, the dead cells are rejected.
- Scarring.A scar of connective tissue forms at the site of exposure. It usually resolves in 2-4 weeks, in severe cases it remains forever.
Depending on the depth of the lesion, the following burns are distinguished:
- Burn I degree. This is a superficial lesion involving only the epidermis. The skin is hyperemic, there is a small edema. Painful sensations expressed only in the first few minutes. Dead epithelial tissues are exfoliated and fall off after 3-5 days. Over the next 5-10 days, the new epithelium regenerates and leaves no trace. In some cases, depigmentation remains (pale pink and white spot).
- Burn II degree. The growth layer is included in the pathological focus. Glands and taste buds are usually preserved. The formation of small bubbles with serous (translucent) content is possible. The edema is pronounced and spreads over the surface and into deep tissues, leading to a slight disruption of the act of swallowing.
- Burn III degree. It is characterized by the defeat of all layers. In the IIIA degree, the deep part of the dermis and the remnants of the small salivary glands will serve as the bottom of the wound, and in the IIIB, the muscular layer. During the first minutes after the injury, the lesion site becomes covered with a black-brown scab with a multitude of sero-hemorrhagic bubbles, prone to fusion. Sensitivity (including pain) is absent. In the absence of microbial flora, an independent cure or the formation of a significant scar can occur.
- IV degree burn - total death of the mucous membrane with a possible lesion of muscle tissue, the tongue (if its integrity is preserved) looks charred, the color is black.
As a rule, such burns are shallow due to the rapid elimination of the provoking factor. In the initial stages, catarrh appears in the superficial tissues of the tongue with a sharp pain. After the area becomes red and swollen, the epithelial membrane is rejected and the symptoms disappear.
In severe cases, transparent blisters form, and after them ulcers and erosion.
A common household trauma is a hot liquid burn. It is not dangerous and does not require seeking medical help (usually pathology is limited to I, less often II degree). Water cools rapidly due to the lower temperature of saliva and surrounding tissues.
Chemical damage can be acute or chronic. A severe burn occurs when highly concentrated substances are injected.
The clinical picture is directly dependent on the duration of exposure and the concentration of the chemical agent. The effect of acids causes the development of coagulation necrosis. A tongue is formed on the tongue, which may have a different color (for example, brown - with burns with sulfuric acid, yellow - with nitric, white - with other, weaker acids). On the periphery of the plaque, edema and hyperemia are expressed.
With alkaline burn, signs of colliquation necrosis appear. The film is not formed, and the pathological process spreads over the surface and into the underlying tissues. In the affected area is the entire mucous and partly muscular membranes of the organ. After the necrotic areas disappear, massive ulcers and erosion appear, which heal for a very long time (up to 4 weeks or more) and may be complicated by bleeding.
Separately, you should consider a burn with ethyl alcohol. Develops when exposed to high concentrations of alcohol (for example, medical grade 96 degree concentrate). The lesion becomes hyperemic. After a few minutes or hours, blisters form with a transparent or hemorrhagic exudate. Then the area is covered with a dark scab. After complete recovery, the burn site is covered with pink pigmentation.
In the event of a shock, all the energy is converted into heat, therefore, the main features are similar to a thermal burn. A characteristic feature is the formation of a whitish zone along the arc of the passage of an energy charge. Such affected areas quickly fall off (2-4 days), and they are replaced by a massive erosive surface that does not heal for a long time.
It is important! The impact of current is extremely dangerous. In addition to thermal damage, systemic changes in electrolytic (changes in blood composition, lysis (destruction) of internal organs), mechanical (breaks in soft tissues due to muscle spasm) and biological (disturbance of blood formation, change in conductivity of nerve fibers, which can lead to paresis and paralysis, various types of arrhythmias).
At the site of exposure to ionizing radiation, filmy radiomucositis develops. On the non-keratinous epithelium, which is the most sensitive and covers the tongue, an area of hyperemia is formed, the mucous membrane begins to lose its properties (elasticity) and becomes folded. Taste sensitivity can be completely lost.
If at this stage the effect of radiation has not ceased, then the tongue is exposed to necrosis, in its place there will be ulcers and erosion. Hyposalivation is characteristic.
The pain is usually not pronounced, as the superficial and deep receptor complexes die first.
First aid and treatment
Burn is a serious problem. If there are signs of a lesion of a degree II or more, then an urgent need to consult a doctor. This will maximize the integrity of the language and its important functional indicators (taste sensitivity, physical activity for the implementation of the full act of swallowing, speech, chewing food).
Special attention requires burns of the tongue in children. A small child may not give a complete picture of the disease or hide the pathology from the parents. In addition, due to negligence, respiratory tract tissues (trachea, bronchi), gastrointestinal tract (esophagus, stomach) may be involved in the pathological process. And clinical signs often have similarities with diseases such as dermatitis, allergic reactions, psoriasis, etc.
Mild burns (I) can be treated independently at home. To do this, after the end of the impact of the traumatic factor, rinse your mouth with cold water.
It is important! Cold products (yogurt, sour cream, etc.) must not be consumed for cooling for 1-2 hours after injury. This can distort the clinic, which will lead to the formulation of an incorrect diagnosis, as well as contribute to infectious and inflammatory complications.
In order to prevent microbial invasion, rinse the oral cavity with antiseptic solutions (0.02% furatsilina solution or hydrogen peroxide) after each meal. To reduce the pain, you can use any spray with anesthetics or systemic nonsteroidal anti-inflammatory drugs (Analgin, Took, Nurofen).
The tactics of first aid and the implementation of further treatment for different etiologies of burns differ.
First aid - washing the affected area with plenty of cold water, preferably boiled or purified, for 5-10 minutes. If the lesion is deep (blisters, scab, erosion), then the oral cavity should be rinsed with antiseptics.
It is important! It is strictly forbidden to use oil immediately after a burn! The superficial oil film isolates the affected tissues and significantly increases the depth of the damage!
Further treatment is carried out in the following areas:
- Anesthesia. Topically used applications or spray 2% lidocaine. When expressed pain - analgesics for oral administration - Analgin, Ketorol.
- Prevention of secondary infection.Antibiotics are prescribed in the presence of an open wound surface. You can use: Amoxicillin 0.5 to 3 times a day or Cefazolin 0.25 to 2 times a day.
- Keratoplasty. The use of oil solutions with vitamins A or E in the form of ointments or gels significantly accelerates the recovery process. Therapy is shown from 3-4 days.
First aid is to use antidotes. In case of acid burns, the surface should be treated with a mild soap solution, 1% lime water or a 0.1% solution of liquid ammonia (3 teaspoons per 200 ml of water). Necrosis caused by alkali, requires the use of weak acids. Perfect solution of citric or acetic acid (0.5%). After, in the presence of open areas, the oral cavity is rinsed with antiseptics. In case of lesions with phenol, the mucosa is treated with castor oil or ethyl alcohol (50%).
Further tactics depend on the patient's condition. With deep lesions, he is sent to a burn center or a surgical hospital.
The patient is prescribed the above described anesthetic therapy, mouth rinsing with antiseptic solutions, as well as substances that accelerate epithelization.
First aid is carried out by analogy with thermal effects. Usually such lesions are not limited to language. There is a high probability that the electric current has penetrated other structures of the body It is necessary to immediately call an ambulance and not take any action, simultaneously watching the general condition, especially for the activity of the cardiovascular system (measurement of blood pressure, frequency and correctness of heart rhythm). The patient, in any case, is sent to the hospital, where a full examination is carried out with the involvement of medical specialists, and then therapy aimed at anesthesia, prevention of infection and, if necessary, antishock therapy.
I and II degree burns are not indications to cancel radiation therapy. Correction of exposure zones is carried out and analgesics are prescribed, as well as gels and ointments with vitamins A and E. Deeper lesions require discontinuation of the treatment of proliferative diseases and prescription of complex treatment with the addition of antiseptics.
The entire period of treatment of any burns is accompanied by a sparing diet with the exception of solid food, spicy, salty, fried and fatty foods. Preference should be given to chopped (mashed) food, steamed.
In the presence of massive lesions (significant and deep areas of necrosis, ulcers and erosion, bleeding, etc.), surgical treatment is indicated. It consists in excision of non-viable tissues and wound closure.
Complications and prognosis
Such injuries can lead to a whole range of secondary changes. These include:
- Infectious and inflammatory diseases. The reason is infection of open wound defects in the absence of adequate antibiotic therapy or antiseptic treatment. It can manifest in the form of glossitis, stomatitis and even sepsis.
- Loss of taste sensitivity. Burns, starting with III degree, lead to a complete loss of taste buds. If the area is significant, there will be no recovery.
- The change in motor activity. The tongue is a muscular organ. Muscle burn contributes to the development of cicatricial changes that limit mobility. Most characteristic of burns of radiation or electrical energy, chemicals.
- Temporary loss of appetite. Pain sensation arising from contact with the tongue, limit speech and eating, which leads to violations of the digestive process, weight loss, sleep disorders and mental activity. Recommended, in severe cases, feeding through a tube or tube.
For superficial burns, the prognosis is usually favorable.Lesions of III and IV degrees lead to pronounced anatomical and physiological changes and disability.
Burns involving respiratory and digestive organs in the pathological process are considered unfavorable. Recovery from this type of development takes a lot of time.
The essence of preventive measures is to prevent injury. Any risk needs to be kept to a minimum:
- If there are young children or adults in need of care in the family, you should limit access to hot products and liquids, isolate any chemicals, exposed areas of electrical wiring and flames.
- Before taking potentially dangerous food (products from the pan, water from the kettle, etc.) or serving it to non-independent persons, it is recommended to check the temperature.
- Observe safety rules when working with electric current and chemical components. For each potentially hazardous substance (especially if it is stored in a regular container, which is typical for household conditions) there must be a label.
- Avoid drug and alcohol abuse. "Blurred mind" is the leading cause of domestic injuries.
Thus, a tongue burn is a common trauma in modern society. The disease can occur due to any reason, but most often - on their own negligence. At the first signs of damage, it is necessary to provide adequate assistance in view of the etiological factor, and in case of deep lesions, especially with electric current, immediately consult a doctor! Only timely and complete therapy will maintain the maximum anatomical and physiological usefulness of such an important organ!