Two Cases of Nonsuicidal Self-Injury Comprising Partial Autoamputation of the Apex of the Tongue

The prevalence of nonsuicidal self-injury (NSSI) in adults is lower than that in adolescents and it is more prevalent in patients with psychiatric disorders. Sleep disturbances such as nightmares are associated with NSSI after accounting for depression; thus, persons with major NSSI sometimes presen...

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Main Authors: Takashi Moriya, Hitoshi Sato, Kenichi Takeda, Kaori Ikezaki, Ryogo Katada, Tatsuo Shirota
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Dentistry
Online Access:http://dx.doi.org/10.1155/2020/8691270
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author Takashi Moriya
Hitoshi Sato
Kenichi Takeda
Kaori Ikezaki
Ryogo Katada
Tatsuo Shirota
author_facet Takashi Moriya
Hitoshi Sato
Kenichi Takeda
Kaori Ikezaki
Ryogo Katada
Tatsuo Shirota
author_sort Takashi Moriya
collection DOAJ
description The prevalence of nonsuicidal self-injury (NSSI) in adults is lower than that in adolescents and it is more prevalent in patients with psychiatric disorders. Sleep disturbances such as nightmares are associated with NSSI after accounting for depression; thus, persons with major NSSI sometimes present at medical institutions during the night seeking emergency treatment. Gingival tissues comprise the most frequent target of self-injury of the oral cavity using oral hygiene tools. Most NSSI in the oral cavity is minor because such tools are blunt. Major NSSI such as autoamputation of the tongue is rare. We describe two patients who partially autoamputated the apex of their own tongues using edged tools. Case 1 was a 55-year-old female with depression who had defaulted from psychiatric intervention. She had cut off her tongue using a Japanese kitchen knife and presented with the dry, necrotic amputated portion and blood oozing from the remainder of her tongue. We debrided and sutured the remainder of the tongue without reattaching the amputated portion. Her postoperative course was uneventful, and she was free of adverse events such as functional disability and wound infection. Case 2 was a 69-year-old female with schizophrenia who had defaulted from psychiatric intervention and had cut off her tongue using scissors. The amputated portion of the tongue was lost and the remainder, which was oozing blood, was debrided and sutured. She defaulted on a follow-up appointment. Neither of these patients had suicidal intent. The prevalence of NSSI across all age groups has recently increased, and the risk that self-injury will become normalized has become a concern. Thus, dentists as well as oral and maxillofacial surgeons should be aware of the possibility that patients will present with major NSSI requiring emergency treatment.
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spelling doaj-art-905d5268a8aa480083282e009b06ead02025-08-20T03:20:31ZengWileyCase Reports in Dentistry2090-64472090-64552020-01-01202010.1155/2020/86912708691270Two Cases of Nonsuicidal Self-Injury Comprising Partial Autoamputation of the Apex of the TongueTakashi Moriya0Hitoshi Sato1Kenichi Takeda2Kaori Ikezaki3Ryogo Katada4Tatsuo Shirota5Department of Oral and Maxillofacial Surgery, Division of Oral Oncology, Showa University School of Dentistry, Tokyo, JapanDepartment of Oral and Maxillofacial Surgery, Division of Oral Oncology, Showa University School of Dentistry, Tokyo, JapanDepartment of Oral and Maxillofacial Surgery, Showa University, School of Dentistry, Tokyo, JapanDepartment of Oral and Maxillofacial Surgery, Showa University, School of Dentistry, Tokyo, JapanDepartment of Oral and Maxillofacial Surgery, Showa University, School of Dentistry, Tokyo, JapanDepartment of Oral and Maxillofacial Surgery, Showa University, School of Dentistry, Tokyo, JapanThe prevalence of nonsuicidal self-injury (NSSI) in adults is lower than that in adolescents and it is more prevalent in patients with psychiatric disorders. Sleep disturbances such as nightmares are associated with NSSI after accounting for depression; thus, persons with major NSSI sometimes present at medical institutions during the night seeking emergency treatment. Gingival tissues comprise the most frequent target of self-injury of the oral cavity using oral hygiene tools. Most NSSI in the oral cavity is minor because such tools are blunt. Major NSSI such as autoamputation of the tongue is rare. We describe two patients who partially autoamputated the apex of their own tongues using edged tools. Case 1 was a 55-year-old female with depression who had defaulted from psychiatric intervention. She had cut off her tongue using a Japanese kitchen knife and presented with the dry, necrotic amputated portion and blood oozing from the remainder of her tongue. We debrided and sutured the remainder of the tongue without reattaching the amputated portion. Her postoperative course was uneventful, and she was free of adverse events such as functional disability and wound infection. Case 2 was a 69-year-old female with schizophrenia who had defaulted from psychiatric intervention and had cut off her tongue using scissors. The amputated portion of the tongue was lost and the remainder, which was oozing blood, was debrided and sutured. She defaulted on a follow-up appointment. Neither of these patients had suicidal intent. The prevalence of NSSI across all age groups has recently increased, and the risk that self-injury will become normalized has become a concern. Thus, dentists as well as oral and maxillofacial surgeons should be aware of the possibility that patients will present with major NSSI requiring emergency treatment.http://dx.doi.org/10.1155/2020/8691270
spellingShingle Takashi Moriya
Hitoshi Sato
Kenichi Takeda
Kaori Ikezaki
Ryogo Katada
Tatsuo Shirota
Two Cases of Nonsuicidal Self-Injury Comprising Partial Autoamputation of the Apex of the Tongue
Case Reports in Dentistry
title Two Cases of Nonsuicidal Self-Injury Comprising Partial Autoamputation of the Apex of the Tongue
title_full Two Cases of Nonsuicidal Self-Injury Comprising Partial Autoamputation of the Apex of the Tongue
title_fullStr Two Cases of Nonsuicidal Self-Injury Comprising Partial Autoamputation of the Apex of the Tongue
title_full_unstemmed Two Cases of Nonsuicidal Self-Injury Comprising Partial Autoamputation of the Apex of the Tongue
title_short Two Cases of Nonsuicidal Self-Injury Comprising Partial Autoamputation of the Apex of the Tongue
title_sort two cases of nonsuicidal self injury comprising partial autoamputation of the apex of the tongue
url http://dx.doi.org/10.1155/2020/8691270
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