Self-mutilation of the tongue in a patient with schizophrenia

J Craniofac Surg. 2014;25(2):e116-8. doi: 10.1097/SCS.0000000000000447.

Abstract

Attempts at tongue replantation are rare, possibly because of the friable nature of the tongue vasculature. We describe the successful replantation of the tongue in a patient with schizophrenia who attempted self-mutilation. Anastomosis of the right deep lingual artery and vein was performed under microscopy. To ensure that the patient did not make another mutilation attempt, he was kept under sedation in the intensive care unit, and a Denhardt mouth gag was placed for 5 days. Currently, his pronunciation is close to normal, and he has recovered some degree of somatic and gustatory sensation. It may be argued that the amputated tongue should be discarded; however, successful replantation can be achieved with high satisfaction for the patient and family, especially in a psychiatric patient.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Amputation, Traumatic / etiology*
  • Amputation, Traumatic / surgery*
  • Aripiprazole
  • Humans
  • Male
  • Medication Adherence
  • Piperazines / administration & dosage
  • Quinolones / administration & dosage
  • Replantation / methods*
  • Schizophrenia, Paranoid / complications*
  • Schizophrenia, Paranoid / drug therapy
  • Self Mutilation / etiology*
  • Tongue / injuries*
  • Tongue / surgery*
  • Young Adult

Substances

  • Piperazines
  • Quinolones
  • Aripiprazole