Article
I thought I would share an interesting case of troublesome mandibular tauri.
This 54-year-old patient attended the oral and maxillofacial outpatients department complaining of bony growths in his lower jaw affecting his speech and causing food impaction. These growths had been present as long as he could remember, but recently had increased in size. The patient was otherwise fit and well.
Examination revealed extensive bilateral lingual tauri of the mandible, almost meeting in the midline (Figure 1). The bony growths were raising his tongue, affecting his speech, and acting as a reservoir for food impaction.
Treatment options of conservative measures versus surgical management were offered, and given the ongoing symptoms, the patient was keen for removal and consented appropriately for damage to the lingual nerve and submandibular ducts.
The patient underwent bilateral tauri removal under local anaesthetic by the author. Mucosal incisions were made over the bony growths to expose, a groove was made along the length of the exostosis using a cooled surgical burr and subsequent controlled fracture of the growth from the lingual aspect of the mandible was carried out using Coupland's elevators. Underlying sharp edges of lingual plate were then smoothed with a cooled surgical burr, and the mucosal flap was closed using resorbable sutures. The procedure was uneventful, and the patient returned home with antiseptic mouthwash and analgesia.
The patient was reviewed in clinic 4 months later, and despite a turbulent post-operative period with significant pain and temporary paraesthesia to the left side of the tongue, was delighted with the result. His speech was audibly improved, and he no longer experienced food impaction. Examination revealed the area to have healed well with no damage to the underlying submandibular ducts and full sensation to his tongue (Figure 2).
Not only has this procedure made vast improvements to the patient's current quality of life, the author also acknowledges that future dental prosthetic management has also been made more straightforward. Although the majority of mandibular tauri are managed conservatively, in the right circumstances surgical management can be of great benefit for patients.