The tongue transverse muscle (or transversus linguae) is one of the key intrinsic muscles of the tongue, responsible for narrowing and elongating the tongue’s shape. While often overlooked, diseases affecting this muscle can impact speech, swallowing, taste, and overall oral health.
Tongue transverse muscle diseases refer to any condition—congenital, inflammatory, traumatic, degenerative, neoplastic, or neurologic—that damages, alters, or impairs the transversus linguae. These conditions may produce changes in muscle size (atrophy, hypertrophy), structure (fibrosis, fatty infiltration), or function (weakness, spasm). They can arise from direct injury, nerve damage, systemic illness (e.g., muscular dystrophies), infections, autoimmune attacks, or tumors. When the transverse muscle is affected, patients may experience altered tongue shape, difficulty speaking (dysarthria), trouble swallowing (dysphagia), or pain.
Anatomy of the Transverse Muscle
Anatomical knowledge helps us understand disease mechanisms and guides diagnosis and treatment.
Structure & Location
-
The transverse muscle runs horizontally through the tongue’s body, deep to the mucosa and between the inferior and superior longitudinal muscles.
-
It forms the “core” of the tongue and interdigitates with fibers from the opposite side.
Origin & Insertion
-
Origin: The median fibrous septum at the tongue’s midline.
-
Insertion: The sides of the tongue, blending into the submucosal tissue near the dorsum and ventral surface.
Blood Supply
-
Primarily from the deep lingual arteries, branches of the lingual artery.
-
Additional small branches from the sublingual artery nourish its ventral portion.
Nerve Supply
-
Innervated by the hypoglossal nerve (cranial nerve XII), which controls all intrinsic and most extrinsic tongue muscles.
Main Functions
-
Narrowing the Tongue: Fibers contract to make the tongue narrower and longer for precise movements.
-
Elongation: Helps extend the tongue forward.
-
Shaping for Speech: Enables articulation of specific consonants (e.g., “s,” “sh”) by narrowing the mid-tongue ridge.
-
Swallowing Assistance: Aids in forming a food bolus and pushing it posteriorly.
-
Taste Presentation: By adjusting tongue shape, it helps spread saliva and taste substances across taste buds.
-
Oral Clearance: Narrows and elongates to sweep debris from the oral cavity.
Types of Transverse Muscle Diseases
Diseases can be grouped by their origin:
-
Congenital Malformations: E.g., intrinsic muscle agenesis, septum defects.
-
Inflammatory Myopathies: Polymyositis, dermatomyositis affecting intrinsic tongue muscles.
-
Neurogenic Disorders: Hypoglossal nerve palsy, motor neuron disease (e.g., ALS).
-
Degenerative Diseases: Muscular dystrophies (e.g., oculopharyngeal muscular dystrophy).
-
Traumatic Injuries: Lacerations, crush injuries to the tongue.
-
Infections: Bacterial (abscess), viral (herpes simplex), fungal.
-
Neoplastic Conditions: Benign (hamartoma), malignant (sarcoma) tumors within the transverse muscle.
-
Fibrosis & Contracture: Post-injury scarring that stiffens and narrows the muscle.
Causes
-
Hypoglossal Nerve Injury (e.g., surgery, stroke)
-
Amyotrophic Lateral Sclerosis (ALS)
-
Polymyositis
-
Dermatomyositis
-
Muscular Dystrophy (e.g., oculopharyngeal)
-
Congenital Septum Defect
-
Direct Trauma (e.g., biting, laceration)
-
Postsurgical Fibrosis (after tongue surgery)
-
Radiation Fibrosis (cancer treatment)
-
Infection (bacterial abscess)
-
Viral Myositis (e.g., herpes)
-
Fungal Infection (e.g., candidiasis penetrating muscle)
-
Autoimmune Attack (e.g., Sjögren’s syndrome)
-
Neoplasm (benign or malignant)
-
Nutritional Deficiency (vitamin E, leading to myopathy)
-
Chronic Alcohol Abuse (alcoholic myopathy)
-
Metabolic Disease (e.g., hypothyroidism causing myxedema)
-
Drug-Induced Myopathy (statins, steroids)
-
Electrical Injury (high-voltage accidents)
-
Granulomatous Disease (e.g., sarcoidosis)
Symptoms
-
Tongue Weakness – Difficulty narrowing the tongue.
-
Atrophy – Noticeable thinning of the tongue’s mid-section.
-
Hypertrophy – Bulging or thickening of the tongue.
-
Dysarthria – Slurred or unclear speech.
-
Dysphagia – Difficulty initiating swallowing.
-
Tongue Pain – Localized muscle ache.
-
Spasms or Fasciculations – Involuntary twitches.
-
Stiffness – Reduced flexibility.
-
Altered Taste – Changes in taste perception.
-
Swelling – Visible enlargement.
-
Ulceration – Sores overlying muscle.
-
Deviation – Tongue veers to one side on protrusion.
-
Reduced Bolus Control – Food spills from sides.
-
Drooling – Poor saliva containment.
-
Choking Episodes – Inadequate bolus formation.
-
Oral Hygiene Issues – Food debris traps in narrow areas.
-
Fatigue – Tongue tires quickly during talking.
-
Speech Fatigue – Voice breaks after prolonged speaking.
-
Symmetry Loss – One side of tongue looks different.
-
Numbness or Tingling – If nerve involvement present.
Diagnostic Tests
-
Physical Exam & Palpation – Assess bulk, tone, pain.
-
Speech & Swallow Evaluation – Clinical speech-language pathologist assessment.
-
Videofluoroscopic Swallow Study – Real-time X-ray during swallowing.
-
MRI of the Tongue – Visualize muscle structure and tumors.
-
Ultrasound – Noninvasive look at muscle thickness and fibrosis.
-
EMG (Electromyography) – Detect nerve-muscle electrical activity.
-
Nerve Conduction Study – Tests hypoglossal nerve function.
-
Muscle Biopsy – Histological diagnosis of myopathies.
-
Blood Tests – CK levels, autoimmune markers (ANA).
-
Genetic Testing – For muscular dystrophy mutations.
-
CT Scan – Rule out calcifications or bony lesions.
-
Biopsy Cytology – For suspected tumors.
-
Fungal Culture – If candidiasis suspected.
-
Viral PCR – Detect viral myositis.
-
Serum Thyroid Panel – Identify hypothyroid myopathy.
-
Nutrition Panel – Vitamin and mineral deficiencies.
-
X-ray Neck – Evaluate bony involvement.
-
Flexible Endoscopic Evaluation – Look at swallowing pharyngeally.
-
Bioelectrical Impedance – Estimate muscle mass.
-
Functional Tongue Strength Test – Pressure measurement devices.
Non-Pharmacological Treatments
-
Speech Therapy Exercises – Tailored tongue narrowing drills.
-
Oral Myofunctional Therapy – Strengthening intrinsic muscles.
-
Tongue Stretching Routines – Improve flexibility and length.
-
Thermotherapy – Warm compresses to reduce stiffness.
-
Cryotherapy – Cold packs for spasm relief.
-
Ultrasound Therapy – Promote muscle healing.
-
Electrical Muscle Stimulation – Activate weak fibers.
-
Biofeedback – Real-time feedback on tongue movement.
-
Massage Therapy – Gentle intraoral massage to reduce fibrosis.
-
Acupuncture – Traditional technique for muscle relaxation.
-
Laser Photobiomodulation – Enhances tissue repair.
-
Chiropractic Posture Correction – Optimize cervical-tongue alignment.
-
Yoga Breathing Exercises – Improve oral-pharyngeal airflow.
-
Occupational Therapy – Adaptive techniques for eating and speaking.
-
Manual Fascial Release – Release myofascial restrictions.
-
Cryoultrasound – Combined cold and ultrasonic therapy.
-
Myofascial Cupping – Suction cups to mobilize tissue.
-
Ergonomic Tongue Splints – Devices to hold tongue in optimal position.
-
Proprioceptive Exercises – Closed-mouth tongue positioning.
-
Nutritional Counseling – Anti-inflammatory diet plan.
-
Hydration Therapy – Ensures muscle pliability.
-
Mind-Body Relaxation – Progressive muscle relaxation techniques.
-
Speech-Driven VR Training – Virtual reality speaking tasks.
-
Tactile Stimulation – Textured pads to stimulate muscle sensors.
-
Manual Resistance Training – Finger-resisted tongue movements.
-
Altered Bolus Consistency – Thicker foods for easier control.
-
Postural Drainage – Head positioning to aid swallowing.
-
Surgical Tape Techniques – External support for tongue shape.
-
Transcutaneous Electrical Nerve Stimulation (TENS) – Pain relief for spasms.
-
Inspiratory Muscle Training – Strengthening breathing muscles to support swallow.
Drugs
-
NSAIDs (e.g., ibuprofen) – Reduce inflammation and pain.
-
Systemic Corticosteroids (e.g., prednisone) – Treat autoimmune myositis.
-
Topical Anesthetics (e.g., lidocaine gel) – Local pain relief.
-
Muscle Relaxants (e.g., baclofen) – Relieve spasticity.
-
Botulinum Toxin Injections – Targeted spasm control.
-
Immunosuppressants (e.g., methotrexate) – For severe myopathies.
-
Antibiotics (e.g., clindamycin) – Treat bacterial abscesses.
-
Antivirals (e.g., acyclovir) – Viral myositis therapy.
-
Antifungals (e.g., fluconazole) – Invasive candidiasis.
-
Statin Adjustment – Switching or reducing statin dose in drug-induced myopathy.
-
Vitamin E Supplements – For deficiency myopathy.
-
Thyroid Hormone Replacement – In hypothyroid myopathy.
-
Analgesics (e.g., acetaminophen) – Mild pain management.
-
Neuromodulators (e.g., gabapentin) – Neuropathic tongue pain.
-
Oral Steroid Mouth Rinse – Local autoimmune lesion control.
-
Calcium Channel Blockers (e.g., diltiazem) – Off-label for muscle relaxation.
-
Anticholinergics (e.g., trihexyphenidyl) – Reduce involuntary movements.
-
Dystonia Agents (e.g., tetrabenazine) – If dystonic component present.
-
Anabolic Steroids (e.g., oxandrolone) – Support muscle mass in dystrophy.
-
Magnesium Supplements – Aid muscle function.
Surgeries
-
Partial Midline Glossectomy – Remove fibrotic transverse fibers.
-
Z-Plasty Reconstruction – Lengthen and reposition muscle.
-
Muscle Release Procedure – Divide contractured bands.
-
Neurotomy/Neurolysis – Relieve nerve entrapment.
-
Nerve Grafting – Repair hypoglossal nerve defects.
-
Microvascular Free Flap – Replace resected tongue segments.
-
Laser Ablation – Remove small tumors or fibrosis.
-
Genioglossus Advancement (adjunct) – Indirectly improves mid-tongue function.
-
Intraoral Scar Revision – Excise scar tissue, reapproximate muscle.
-
Tongue Splint Insertion – Implant to support muscle architecture.
Preventions
-
Maintain Good Oral Hygiene – Prevent infections that can spread to muscle.
-
Promptly Treat Infections – Early antibiotics/antivirals.
-
Protect Tongue During Surgery – Meticulous technique to avoid nerve injury.
-
Radiation Shielding – Limit exposure during head/neck radiotherapy.
-
Avoid Tongue Trauma – Use mouthguards in sports.
-
Regular Dental Visits – Early detection of lesions.
-
Balanced Diet & Hydration – Support muscle health.
-
Manage Systemic Diseases – Control diabetes, thyroid disorders.
-
Careful Medication Management – Monitor for myotoxic drugs.
-
Tongue Exercise Routine – Daily myofunctional drills to keep muscle strong.
When to See a Doctor
-
Persistent Tongue Weakness: Lasting more than 2 weeks without improvement.
-
Severe Pain or Ulceration: Pain not relieved by over-the-counter remedies or open sores.
-
Speech or Swallowing Difficulty: New or worsening dysarthria/dysphagia.
-
Visible Mass or Growth: Any lump or thickening in the tongue.
-
Unexplained Atrophy or Hypertrophy: Noticeable changes in tongue size.
-
Fasciculations or Spasms: Involuntary movements interfering with function.
-
Neurologic Signs: Chewing, facial changes, or drooling accompanying tongue issues.
FAQs
-
What is the transverse tongue muscle?
-
It’s an intrinsic muscle that narrows and elongates your tongue, helping with speech and swallowing.
-
-
Can I feel my transverse muscle?
-
Not directly, but you can feel movement when you narrow or elongate your tongue.
-
-
What causes tongue muscle atrophy?
-
Nerve damage, disuse, autoimmune disorders, or systemic illnesses.
-
-
Are tongue muscle diseases common?
-
They’re relatively rare but can occur with systemic diseases or after local injuries.
-
-
How are they diagnosed?
-
Through physical exams, imaging (MRI/ultrasound), EMG, and sometimes biopsy.
-
-
Can speech therapy help?
-
Yes—targeted exercises can strengthen and improve coordination.
-
-
When is surgery needed?
-
For severe contractures, tumors, or nerve repairs not responding to other treatments.
-
-
Are there medications for tongue muscle spasm?
-
Muscle relaxants, botulinum toxin, and certain neuromodulators can help.
-
-
Is tongue massage effective?
-
Gentle intraoral massage can reduce fibrosis and improve flexibility.
-
-
Can I prevent these diseases?
-
Good oral care, avoiding trauma, and managing systemic health help reduce risk.
-
Is it painful?
-
Some conditions cause aching or sharp pain, especially with inflammation.
-
Will my speech be permanently affected?
-
Many patients improve with therapy; permanent changes are uncommon with timely treatment.
-
How long does recovery take?
-
Depends on the cause—days for minor myositis, months for post-surgical healing.
-
Can nutrition play a role?
-
Yes—adequate protein, vitamins (especially E), and hydration support muscle health.
-
Where can I learn more?
-
Consult peer-reviewed anatomy texts (e.g., Gray’s Anatomy) or reputable medical websites.
Conclusion:
Understanding the transverse tongue muscle’s anatomy and recognizing disease signs early can vastly improve outcomes. A combination of targeted exercises, timely diagnostics, appropriate medications, and, when needed, surgical intervention helps restore function and quality of life. Always consult a healthcare professional if you notice persistent or severe tongue issues.
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.
The article is written by Team Rxharun and reviewed by the Rx Editorial Board Members
Last Updated: April 23, 2025.
