What is Tongue Biopsy

Tongue biopsy is a procedure to remove a small piece of tissue from the tongue so that the tongue cells can be examined under a microscope. You may need this procedure if you have an abnormal growth (lesion) in or on your tongue.

Tongue growths can be fluid-filled (cysts) or solid masses (tumors). A tongue biopsy can help your health care provider make a diagnosis and plan the right treatment for you.

There are several types of tongue biopsy. In this procedure, your health care provider may remove:

• A slice of the lesion (incisional biopsy).
• The whole lesion (excisional biopsy).
• A piece of the lesion (punch biopsy).
• A core of the lesion (needle biopsy).

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Swelling.
• Severe swelling that interferes with swallowing or breathing.

What happens before the procedure?

• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Plan to have someone take you home from the hospital or clinic.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• To lower your risk of infection:

• Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube may be inserted into one of your veins.
• The lesion may be sprayed with numbing medicine.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
• Your tongue may be held steady with a gauze pad.
• For an incisional biopsy:
  • A slice of tissue will be removed using a surgical knife.
  • The edges of the incision may be closed with an absorbable stitch (suture), or the incision may be left open to heal on its own.
• For an excisional biopsy:
  • An incision will be made around the lesion and the entire lesion will be removed.
  • The edges of the incision may be closed with absorbable sutures or the incision may be left open to heal on its own.
• For a punch biopsy, a surgical biopsy instrument will be used to remove a piece of the lesion.
• For a needle biopsy, a hollow needle will be inserted into the area of the lesion and a core of tissue or cells will be removed.
• Your mouth will be rinsed out and pressure may be applied with a gauze pad until bleeding stops.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• Do not drive for 24 hours if you received a sedative.

Tongue Biopsy, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Temporary tongue numbness.
• Pain and soreness.
• Bloody spit.
• Swelling.

Follow these instructions at home:

Mouth Care

• Follow instructions from your health care provider about how to take care of your biopsy site.
• Rinse your mouth with a cool salt and soda water mixture 3–4 times per day, or as many times as needed. To make a salt and soda water mixture, completely dissolve ½-1 tsp of salt and 1 tsp of baking soda in 1 cup of warm water. If this causes discomfort, rinse your mouth with water only and keep your mouth clean.
• Check your biopsy site every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Pus or a bad smell.

Driving

• Do not drive or use heavy machinery while taking prescription pain medicine.
• Do not drive for 24 hours if you received a medicine to help you relax (sedative) during your procedure.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Raise (elevate) your head above the level of your heart while you are sitting or lying down.

General instructions

• Do not chew food until your mouth stops being numb. You may need to avoid hot and spicy foods or foods that are difficult to chew and swallow. Avoid these foods until your health care provider says that you can return to your normal diet.
• Follow instructions from your health care provider about other eating or drinking restrictions.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever or chills.
• You have more redness, swelling, or pain around your biopsy site.
• You have more fluid or blood coming from your biopsy site.
• You have pus or a bad smell coming from your biopsy site.
• You have pain that does not get better with medicine.
• You have tongue pain or swelling that causes you to have trouble eating or drinking.

Get help right away if:

• You have new bleeding that does not stop after you apply pressure with a gauze pad.
• You are unable to swallow.
• You have difficulty breathing.