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Spontaneous fracture of the genial tubercles: a case report

From Volume 39, Issue 1, January 2012 | Pages 63-64

Authors

Peter J Burnett

BDS

Senior House Officer, Liverpool University Dental Hospital

Articles by Peter J Burnett

Paul P Nixon

BDS, FDSRCS(Eng), DDRRCR

Consultant in Maxillofacial Radiology, Department of Radiology, Liverpool University Dental Hospital and the Royal Liverpool University Hospital

Articles by Paul P Nixon

Simon N Rogers

FRCS FRCS (maxfac) MD

Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, UK and Edge Hill University, Liverpool and Evidence-Based Practice Research Centre (EPRC), Faculty of Health, Edge Hill University, St Helens Road, Ormskirk

Articles by Simon N Rogers

Abstract

Spontaneous fracture of the genial tubercles is rare and, of the 13 reported cases in the literature, all involve the older edentulous patient. A case of genial tubercle fracture in a 62-year-old edentulous female is presented. The symptoms are pain and swelling of the floor of the mouth and restricted tongue movement. Surgical intervention was not required and a complete recovery without loss of function was made.

Clinical Relevance: This case aims to make practitioners aware of genial tubercle fracture as a possible diagnosis when the older edentulous patient presents with pain and swelling in the floor of the mouth.

Article

The genial tubercles are a pair of bony projections, which are situated on the lingual surface of the anterior mandible, midway between the superior and inferior borders. These projections are part of the origin of the genioglossus and geniohyoid muscles.

Although usually quite small, the genial tubercles can increase in size and extend inwards from the lingual surface of the mandible, which can interfere with the seating of the lower denture.

A 62-year-old edentulous woman presented with pain and swelling of the floor of her mouth which affected her ability to swallow and also wear her lower denture. There was no relevant medical history and she had worn complete dentures for the past 30 years.

While eating, 4 days previously, she heard a cracking noise which was followed by severe pain. This lasted through the night but was eased by analgesics.

On examination, there was bilateral swelling and haematoma of the floor of the mouth (Figure 1). The submandibular salivary ducts were patent, salivary secretion was normal and there was a full range of tongue movement.

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