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Lingual Septum

The lingual septum is a fibrous vertical partition that runs in the midline of the tongue, extending from the floor of the mouth to the dorsal surface, dividing the tongue into right and left halves. It contains connective tissue, minor neurovascular bundles, and is closely associated with the intrinsic muscles of the tongue. Understanding its anatomy, function, and imaging characteristics is essential for radiologists, dentists, oral surgeons, and ENT specialists, particularly when assessing tumors, trauma, or congenital anomalies.

Synonyms

  • Median lingual septum

  • Tongue midline fibrous partition

  • Lingual median fibrous septum

  • Median fibrous tongue septum

Function

  • Divides the tongue into right and left halves

  • Provides structural support for intrinsic tongue muscles

  • Serves as a conduit for neurovascular bundles

  • Plays a role in tongue mobility and articulation

MRI Appearance

T1-weighted images:

  • The lingual septum appears as a thin, linear structure of intermediate signal, slightly hypointense compared to surrounding tongue musculature.

  • Surrounded by tongue muscles, which are intermediate signal, and any intraoral air appears as signal void (black).

  • Fat in the sublingual space is hyperintense, providing contrast with the septum.

  • Pathology such as cysts, fibrous lesions, or tumors may appear hypo- to isointense and enhance with contrast.

T2-weighted images:

  • The septum remains linear with intermediate to hyperintense signal, while edema, cysts, or fluid collections appear hyperintense, highlighting abnormalities.

  • Air remains signal void, sharply defining the tongue surface and floor of the mouth.

STIR (Short Tau Inversion Recovery):

  • Fat suppression removes high signal from sublingual fat, emphasizing pathological changes.

  • Normal septum is low-to-intermediate signal, while lesions, inflammation, or edema appear bright hyperintense.

CT Appearance

  • On non-contrast CT, the lingual septum is seen as a thin soft tissue density structure within the midline of the tongue.

  • The tongue itself is soft tissue density, while air in the oral cavity appears hypodense (black), sharply delineating the septum.

  • The septum may not always be visible unless there is associated pathology, swelling, or asymmetry.

  • CT is particularly useful for assessing trauma, foreign bodies, tumors, or calcifications in the tongue region.

MRI images

Lingual septum mri image -img-00000-00000