Tongue scalloping: A novel clinical indicator in obstructive sleep apnea - An overlooked but insightful clinical sign

Obstructive sleep apnea (OSA) is a highly prevalent, yet frequently underdiagnosed condition that significantly contributes to cardiovascular morbidity, neurocognitive dysfunction, and reduced quality of life. Tongue scalloping, or “lingua indentata,” is an easily recognizable clinical sign characterized by indentations along the lateral border of the tongue. Although conventionally considered a benign dental or nutritional finding, recent evidence suggests a strong association between tongue scalloping and OSA, especially in individuals with macroglossia or retrognathia. This article explores the anatomical basis, clinical implications, and emerging diagnostic relevance of tongue scalloping as a novel bedside screening clue for OSA.