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Tongue & Thyroid Development

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Topic updated on 04/13/14 9:26pm

Tongue Development
  •  Anterior 2/3 of tongue
    • derived from 1st branchial arch
      • sensation: lingual branch of CN V3
      • taste: chorda tympani branch of CN VII
  • Posterior 1/3 
    • derived from 3rd and 4th branchial arches
      • sensation and taste: CN IX
      • extreme posterior sensation and taste: CN X
  • Motor innervation
    • all muscles of tongue: CN XII except palatoglossus (CN X)
    • muscles of tongue are derived from myoblasts originating from the occipital somites
Thyroid Development
  •  Thyroid diverticulum 
    • develops from endodermal lining of foregut
    • appears from the midline of the floor of the primitive pharynx
    • descends into the neck maintaining a connection to the tongue through the thyroglossal duct
      • thyroglossal duct degenerates during development
        • may remain as pyramidal lobe of thyroid
        • foramen cecum: remnant of thyroglossal duct
  • Thyroglossal duct cyst 
    • persistent thyroglossal duct forming a cyst in midline of neck near hyoid bone
      • other location is at base of tongue: lingual cyst
    • cyst moves during swallowing
  • Ectopic thyroid tissue 
    • failure of migration downward can result in ectopic thyroid tissue forming anywhere along the thyroglossal duct's path
    • tongue is the most common site of ectopic thyroid tissue 


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(M1.EB.38) A 4-year-old-female presents with a flattened, reddish 2 cm lump located at the base of the tongue. The patient's mother reports her having trouble swallowing, often leading to feeding difficulties. The mother also reports lethargy, constipation, dry skin, and hypothermia. Which of the following is the most appropriate management of this patient’s presentation? Topic Review Topic

1. Combination therapy of methimazole and Beta-blockers
2. Week-long course of penicillin
3. Radioactive iodine ablation
4. Surgical excision of mass followed by levothyroxine administration
5. No treatment is necessary, counsel mother on alternative feeding techniques

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