Lingual abscess: diagnosis and treatment.

Background: Lingual abscesses are very rare, and as a result, the individual surgeon usually lacks experience in the diagnosis and therapy of this entity. We present four cases of abscesses of the tongue diagnosed and treated during the past 2 years.

Methods: The medical records, films, and charts of four patients with lingual abscess were retrospectively reviewed. The clinical presentation, radiographic features, treatment, and outcome of the cases were examined.

Results: Diagnosis was obtained by clinical examination and CT. In all cases, we avoided incision and drainage and preferred draining the abscess and aspirating pus with a large-bore needle through the inferior surface of the tongue. All patients responded remarkably well and did not have any recurrence.

Conclusions: Lingual abscesses are rare conditions. In contrast to the approach in cases of most deep neck space infections, a more conservative therapeutic approach by needle-aspiration is effective and has the advantages of not exacerbating the edema of the tongue and of avoiding airway compromise.