-
Journal of the American Dental... Apr 2023
Topics: Humans; Macroglossia
PubMed: 35339262
DOI: 10.1016/j.adaj.2022.02.006 -
The Journal of Craniofacial SurgeryMacroglossia is a term used to describe a large tongue which protrudes outside of the mouth while in a resting position (Balaji, 2013). It is a cardinal sign in children... (Review)
Review
INTRODUCTION
Macroglossia is a term used to describe a large tongue which protrudes outside of the mouth while in a resting position (Balaji, 2013). It is a cardinal sign in children with Beckwith-Wiedemann syndrome and can also be found in children with Down syndrome and Klippel-Trenaunay-Weber syndrome. Macroglossia can lead to airway and feeding difficulties, as well as problems with speech, drooling, and cosmesis. We present a review of tongue reduction operations performed for macroglossia over a 10-year period in Northern Ireland.
METHODS
We performed a retrospective review of the medical notes of those children identified to have undergone a tongue reduction procedure in the regional pediatric hospital. We reviewed the presenting symptoms and concerns, the operative technique used, postoperative outcomes, and follow up. Outcomes data included improvements in symptoms, complications, and the need for revision procedures.
RESULTS
Six children underwent tongue reduction procedures over a 10-year period. Age range at time of surgery was between 4 months to 10 years 3 months. Five children had an underlying diagnosis of Beckwith-Wiedemann syndrome and 1 child had Down syndrome. One child underwent a second tongue reduction for mild tongue protrusion at the 5-year follow up. There were no complications in relation to tongue reduction surgery for any of the children and importantly, there were no airway complications in our series. All patients were found to have improved feeding, better tongue position in the oral cavity, reduced drooling, and better speech development following surgery.
CONCLUSION
Symptomatic macroglossia requiring a tongue reduction procedure is relatively rare and these procedures are, therefore, uncommonly performed. Despite the rarity of this procedure, when it is required, it can be life saving for some infants and children, and life altering for the remainder. Improvements in airway, feeding, speech, and psychosocial wellbeing are the desired outcomes with this procedure. Throughout our 10-year series we have found it to be a relatively safe procedure but potentially anesthetically challenging. We have demonstrated both good short and long-term outcomes for these children.
Topics: Beckwith-Wiedemann Syndrome; Child; Glossectomy; Humans; Infant; Macroglossia; Retrospective Studies; Tongue
PubMed: 33235175
DOI: 10.1097/SCS.0000000000007276 -
The Journal of the Louisiana State... Aug 1990Macroglossia is defined as a resting tongue that protrudes beyond the teeth or alveolar ridge. Complications of macroglossia include articulation errors, mandibular... (Review)
Review
Macroglossia is defined as a resting tongue that protrudes beyond the teeth or alveolar ridge. Complications of macroglossia include articulation errors, mandibular deformities, deglutition difficulties, and airway obstruction. Etiologies include hypothyroidism, the Beckwith-Wiedemann syndrome, lymphangiomatosis, and amyloidosis. Surgical correction of this condition at an early age may prevent or minimize the maxillofacial deformities and speech defects.
Topics: Humans; Macroglossia
PubMed: 2230521
DOI: No ID Found -
Annales de Dermatologie Et de... Dec 2022The objective of this literature review was to list the different etiologies of macroglossia reported in the literature, to identify characteristics that might guide... (Review)
Review
BACKGROUND
The objective of this literature review was to list the different etiologies of macroglossia reported in the literature, to identify characteristics that might guide diagnosis, and to create a diagnostic algorithm.
METHODS
The bibliographic search was carried out between October 2019 and July 2020 in the PubMed research base using the keywords "macroglossia" (MESH) and/or "tongue enlargement".
RESULTS
Of the 1711 references identified, 615 articles were excluded, and 1096 abstracts were reviewed. We classified the different etiologies identified according to their mechanism and whether they were congenital or acquired. The etiologies are divided into the following categories: genetic malformation syndromes, non-syndromic congenital malformations, endocrinopathies, neuromuscular diseases, storage disorders, infectious, inflammatory, traumatic, and iatrogenic diseases.
CONCLUSION
Based on this review, we propose a diagnostic algorithm for macroglossia according to the characteristics described. The most common diagnoses among acquired causes were amyloidosis (13.7%), endocrinopathies (8.8%), myopathies (4%) and tongue tumors (6.7%). The most common congenital causes were aneuploidy, lymphatic malformations, and Beckwith-Wiedemann syndrome, which is the main cause of congenital macroglossia, even if it appears isolated.
Topics: Humans; Algorithms; Beckwith-Wiedemann Syndrome; Macroglossia
PubMed: 36229262
DOI: 10.1016/j.annder.2022.03.011 -
International Dental Journal Apr 2011Macroglossia is defined as an enlarged tongue and it is usually clinically diagnosed. Pseudomacryglossia concerns a tongue that is of normal size but gives a false...
Macroglossia is defined as an enlarged tongue and it is usually clinically diagnosed. Pseudomacryglossia concerns a tongue that is of normal size but gives a false impression of being too large in relation to adjacent anatomical structures. The causes of macroglossia are numerous and this is why various classifications have been proposed for this condition. The consequences of macroglossia usually include a possible malfunction of the stomatognathic system, breathing and speech problems, increased mandible size, tooth spacing, diastema and other orthodontic abnormalities. The treatment of macroglossia depends on its aetiology and generally includes correcting the systemic disease underlying the increase in lingual mass, surgical treatment, radiotherapy and treatment of orthodontic abnormalities that might have been caused by the condition.
Topics: Glossectomy; Humans; Macroglossia
PubMed: 21554274
DOI: 10.1111/j.1875-595X.2011.00015.x -
Ryoikibetsu Shokogun Shirizu 2001
-
Canadian Journal of Anaesthesia =... Sep 2020
Topics: Craniocerebral Trauma; Humans; Macroglossia; Tongue
PubMed: 32319027
DOI: 10.1007/s12630-020-01672-x -
Current Opinion in Otolaryngology &... Dec 2009To discuss current literature regarding the diagnosis, assessment and treatment of macroglossia in pediatric patients. (Review)
Review
PURPOSE OF REVIEW
To discuss current literature regarding the diagnosis, assessment and treatment of macroglossia in pediatric patients.
RECENT FINDINGS
Genetic reasons for macroglossia are being identified. Sleep endoscopy and imaging allow assessment of tongue base-induced obstructive sleep apnea. Dental malocclusion and macroglossia are associated. Technical modifications to increase macroglossia surgery safety and efficacy have been described. An anatomic and functional basis for tongue reduction surgery is being developed.
SUMMARY
Macroglossia, when present, can cause a number of functional and aesthetic problems for affected individuals. Treatment of this unusual problem is challenging and controversial.
Topics: Child; Humans; Macroglossia
PubMed: 19713845
DOI: 10.1097/MOO.0b013e3283317f89 -
Archives of Disease in Childhood.... May 2024
Topics: Humans; Macroglossia; Infant; Male; Female
PubMed: 38373825
DOI: 10.1136/archdischild-2023-326806 -
Current Opinion in Otolaryngology &... Aug 2015To discuss the current surgical management of macroglossia. (Review)
Review
PURPOSE OF REVIEW
To discuss the current surgical management of macroglossia.
RECENT FINDINGS
Traditional surgical management of severe macroglossia has been with anterior wedge or keyhole resection. Long-term follow-up has been limited, and only recently have assessments been done regarding functional and aesthetic outcomes. New methods including double stellate and combination approaches have shown promise, though with limited case size reports. Addressing macroglossia in three dimensions may be the most effective way of achieving positive positional, speech and aesthetic outcomes, but comparative studies are lacking. Other causes of macroglossia, such as vascular malformations, can be managed with less aggressive measures such as laser and radio-frequency ablation.
SUMMARY
The aggressiveness of the management should match the severity of the symptoms. The anterior wedge resection and modified keyhole incisions are the most well studied operative strategies. Short and long-term outcome data are limited, and neither method is definitively superior. Less aggressive measures are options for less severe macroglossia. Surgical management of macroglossia should be tailored to each individual patient and in accordance to surgeon experience and expertise.
Topics: Glossectomy; Humans; Macroglossia; Recovery of Function
PubMed: 26101871
DOI: 10.1097/MOO.0000000000000171