[Congenital macroglossia: cyto-biometrical data on a case of muscular macroglossia].
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Biometry↗
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Macroglossia: a review of the condition and a new classification.
In studying macroglossia, no one has described normal tongue size or applied direct measurement to the pathologically enlarged tongue. Since macroglossia is primarily a condition that requires treatment on a symptomatic basis, definition of the problem in clinical terms is the most useful form for the practitioner. Based on published reports and our clinical experience, a classification scheme for macroglossia has been formulated. The concept of true macroglossia and relative macroglossia form a framework that categorizes acquired and congenital forms of tongue enlargement. True macroglossia exists when histologic abnormalities correlate with the clinical findings of tongue enlargement. Vascular malformations, muscular enlargement, and tumors are the most common forms of true macroglossia. Relative macroglossia includes those cases of apparent tongue enlargement in which the histology does not provide a pathologic explanation. Down's syndrome is a commonly quoted cause for tongue enlargement and is a form of relative macroglossia. The development of this classification system establishes an approach and common terminology on which therapy, research, and communication can be based.
Beckwith-Wiedemann Syndrome↗
Surgical management of lymphangiomatous or lymphangiohemangiomatous macroglossia.
PURPOSE: The specific aim of this retrospective investigation was to evaluate effects of lymphangiomatous or lymphangiohemangiomatous macroglossia managed by Jian or Dingman glossectomy. PATIENTS AND METHODS: Between 1992 and 2002, we treated surgically a total of 7 patients (5 males and 2 females) with lymphangiomatous or lymphangiohemangiomatous macroglossia. Of the 7 patients, 3 had lymphangiohemangiomatous macroglossia and 4 had lymphangiomatous macroglossia. Lymphangioma or lymphangiohemangioma, which is localized in the anterior middle two thirds of the tongue, was present in 4 patients who were operated on with Jian glossectomy. Lymphangiomatous macroglossia, which is localized in the anterior and lateral two thirds of the tongue, was present in 3 patients, who were treated with Dingman glossectomy. The complications and recurrences after surgical management were analyzed. RESULTS: After a follow-up period of 1 to 10 years, cosmesis and function improved after surgery in all 7 patients. The tongue healed well, and the patients had no long-term complications. Postoperatively, tongue protrusion resolved in all the patients. All parents were satisfied with the postoperative appearance and did well with oral feedings. The physiologic functions that benefited most with surgical treatment were respiratory and deglutition. No patient in this investigation had macroglossia recurrence. CONCLUSIONS: Jian or Dingman glossectomy is an effective surgical technique for lymphangiomatous or lymphangiohemangiomatous macroglossia, but both of these techniques have unique indications. Surgical techniques must be chosen in accordance with the position of lymphangiomas or lymphangiohemangiomas.
Adolescent↗
Surgical management of macroglossia: discussion of 7 cases.
OBJECTIVE: We present an overview of international literature concerning macroglossia-related etiology, clinical and instrumental diagnoses, surgical treatments, complications, and recurrences. Moreover, we present a series of cases of patients affected by macroglossia who have been treated surgically at the Department of Maxillofacial Surgery of the University of Rome "La Sapienza". METHODS: Between 1990 and 1999, only after attempts to solve this pathologic condition with medical and orthodontic treatment, we treated surgically a total of 7 patients (4 male and 3 female). The surgical techniques used were Köle glossectomy and Dingman and Grabb glossectomy. We analyzed the clinical and instrumental study and the surgical treatment, including possible complications and recurrences. RESULTS: After follow-up of a period from 2 to 9 years, macroglossia recurrences were absent, showing that the Köle and the Dingman and Grabb glossectomies are viable surgical options for treatment of macroglossia. CONCLUSION: The best therapy for each case macroglossia must be carefully evaluated, with the right medical therapy and orthodontic therapy attempted first and surgical treatment performed only when the first and second therapy fail. Moreover, surgical techniques must be chosen in accordance with the functional results that one wants to achieve and must be the most conservative technique to preserve the vascular-nerve bundle.
Adolescent↗
Surgical management of macroglossia in children.
Congenital macroglossia is associated with a variety of syndromes, most commonly Down syndrome and Beckwith-Widemann syndrome. Clinically, macroglossia may result in respiratory compromise, dysphagia, and poor cosmesis. A variety of treatments have been proposed, with surgical resection being the most common. We review management and describe a new surgical technique, consisting of a keyhole resection to decrease the width and length of the tongue. Between 1990 and 1992, five keyhole resections for congenital macroglossia were performed on four consecutive children at Texas Children's Hospital, Baylor College of Medicine, Houston. Patients had improved cosmesis and improved function of the oropharyngeal airway, with no change in speech and feeding. Keyhole resection is an effective treatment for macroglossia.
Child, Preschool↗
Acute exacerbation of macroglossia leading to necrosis of the anterior third of the tongue.
Macroglossia is defined as an enlarged tongue that protrudes beyond the teeth or the alveolar ridge in the resting position. Macroglossia may be classified into generalised and localised based on the extent of tongue involvement. Each of these groups can be subdivided into congenital, inflammatory, traumatic, metabolic and neoplastic lesions [Myer III CM, Hotaling AJ, Reilly JS. The diagnosis and treatment of macroglossia in children. Ear Nose Throat J 1986;65:444-8]. The congenital causes are vascular anomalies such as haemangioma and lymphovenous malformations. We report the case of a large lymphovenous malformation of the tongue in a 17 month old child who developed an acute exacerbation of macroglossia following trauma. This eventually led to necrosis of the anterior third of his tongue requiring a partial glossectomy.
Accidental Falls↗
Postoperative macroglossia causing airway obstruction.
Macroglossia can cause a wide spectrum of problems in the pediatric population. Airway obstruction is the most severe of the sequelae and must be handled promptly. Typically, congenital macroglossia does not present with sudden airway obstruction, however, traumatic or postoperative macroglossia can. Iatrogenic postoperative macroglossia is presented and mechanisms of injury discussed. Preventative and therapeutic measures are outlined.
Achondroplasia↗
Diagnosis of macroglossia and indications for reduction glossectomy.
Macroglossia can create dentomusculoskeletal deformities, instability of orthodontic and orthognathic surgical procedures, and masticatory, speech, and airway problems. The cause of macroglossia must be clearly defined, and true macroglossia separated from pseudomacroglossia (displacement of the tongue created by anatomic factors other than tongue size alone). This article discusses the signs and symptoms of macroglossia, including the clinical and radiographic features, treatment techniques, as well as previously reported results. Cases are shown to illustrate the applicability of this technique.
Adolescent↗
Postoperative massive macroglossia in Klippel-Feil syndrome after posterior occipitocervical fixation surgery in the sitting position.
Postoperative macroglossia is a very rare complication associated with neurosurgical procedures. There have only been 16 cases reported in the literature. With regard to spine surgery, however, only two cases have been reported. The first report was a case where the complication of postoperative macroglossia occurred during occipitocervical spine surgery in a sitting position. In this second documented incident, we report a case of massive macroglossia, in a 44-year-old man, following posterior craniocervical fixation and fusion surgery performed in a sitting position. The patient had Klippel-Feil syndrome with basilar invagination preoperatively. Postoperative macroglossia was treated by partial glossectomy, because medical management (anti-edema therapy) failed. This complication is a life-threatening complication and must be treated promptly. Diverse etiologic mechanisms are discussed along with preventive and therapeutic measures.
Adult↗
[Macroglossia and amyloidosis. Apropos of a case].
In the present treatise, a classification scheme for macroglossia has been formulated, based on clinical and etiological features of an enlarged tongue. The pathogenesis of each form-type of macroglossia is then described. In addition to, the authors report a case of female patient suffering from macroglossia, who was admitted in their Clinic. This pathological condition was the single and the very first clinical sign (symptom) of her, and (which) led up to the diagnosis of amyloidosis. They present the procedure of the diagnosis and differential diagnosis for this patient, they emphasize their conclusions (considerations) and make comments on the coexistence or correlation of macroglossia with amyloidosis.
Aged↗
Macroglossia: a case study.
UNLABELLED: A young child with macroglossia of unknown cause was seen for treatment to modify resting tongue posture and improve speech sound production. Evaluation of the treatments indicated positive change in resting tongue posture and a modest change in speech sound production. Treatment for such patients can be complex and must consider orthodontic and/or surgical interventions, because an enlarged tongue can influence growth, development, and physiology of the oropharyngeal complex. The speech-language pathologist must be prepared to deal with the complex of problems demonstrated by patients with macroglossia during growth and development. LEARNING OUTCOMES: (1) As a result of this activity, the participant will be able to describe the sequelae of macroglossia. (2) As a result of this activity, the participant will be able to identify appropriate treatment options for children with macroglossia.
Articulation Disorders↗
[A case report of macroglossia following tongue bite (author's transl)].
A variety of congenital or acquired diseases may cause macroglossia. We report the case study of a 25 year old patient with Down's Syndrome who developed macroglossia after injury to the tongue from a self-inflicted bite. Conservative therapy for one month through wound revision, antibiotics and antiphlogistics was only successful in controlling infection but failed to prevent the occurrence of a massive macroglossia. This latter problem could only be managed through reconstructive surgery. Histological studies of tissue taken from the tongue revealed the presence of an interstitial edema containing protein, but without evidence for mucopolysaccharides, glycogen or amyloid. A network of dilated blood and lymphatic vessels with partial stenoses caused by organized thrombosis and proliferation of endothelial cells could be observed, suggesting the presence of a congenital lymphangio-hemangioma. However, we believe that these findings were the result of the obliteration of lymphatic and blood vessels through trauma and inflammation to produce the patient's macroglossia.
Adult↗
Symptomatic macroglossia and tongue myositis in polymyositis: treatment with corticosteroids and intravenous immunoglobulin.
Symptomatic macroglossia occurs in some rare congenital muscle diseases, such as Becker's and Duchenne's dystrophies or Pompe's disease. Herein we describe a case of symptomatic macroglossia with myositis of the tongue occurring in a patient with polymyositis. Tongue myositis was evidenced by dysarthria, frequent biting during mastication, swallowing difficulties without aspiration, and noisy breathing. Magnetic resonance imaging showed homogeneous hypertrophy of the tongue, especially the mouth's floor muscles. The diagnosis of tongue myositis was established by electromyography and biopsy. No other cause for the macroglossia was found. Symptoms resolved quickly with corticosteroid and intravenous immunoglobulin treatment. To our knowledge, this is the first reported case of symptomatic tongue myositis occurring in the course of polymyositis.
Humans↗
Macroglossia and carpal tunnel syndrome associated with multiple myeloma: a case report.
BACKGROUND: Macroglossia is an unusual symptom in primary care. It may be an indicator of an underlying plasma cell dyscrasia or multiple myeloma in the elderly. AIM: To describe such a case of multiple myeloma. RESULTS: A 69-year-old man,with a recent history of bilateral carpal tunnel repair, presented to his GP with progressive macroglossia. This was eventually diagnosed as being due to amyloidosis, secondary to multiple myeloma. CONCLUSION: Physicians should be aware of the association between macroglossia, carpal tunnel syndrome and multiple myeloma in this age group.
Aged↗
Self-inflicted traumatic macroglossia.
Macroglossia is a potentially life-threatening problem. The multiple aetiologies responsible for this condition include cysts, tumours, amyloidosis, angioedema, and infections. Although injuries to the oral cavity are common, self-inflicted traumatic macroglossia is not common. We report a case of a comatose patient with limb contractures and severe trismus who developed entrapment of the tongue with progressive macroglossia and near auto-amputation of the tongue. The importance of early recognition and treatment of tongue entrapment in comatose patients is emphasised since this is a potentially reversible condition.
Adult↗
Massive macroglossia as a presenting feature of hypothyroid-associated pericardial effusion.
An 81-year-old woman presented with massive macroglossia and signs of both hypothyroidism and pericardial tamponade. Drainage of the pericardial effusion produced dramatic resolution of the macroglossia. Marked elevation of central venous pressure may result in macroglossia, possibly because of anomalous venous drainage of the tongue.
Aged↗
[Macroglossia after neck clipping of a VA-PICA (vertebral artery-posterior inferior cerebellar artery) aneurysm].
A case of macroglossia following neck clipping of VA-PICA aneurysm is described. The etiology of this rare complication has been thought to be venous obstruction related to extreme flexion of the head in the sitting position. On the other hand, Moore et al recently proposed that the primary mechanism of macroglossia after posterior fossa exploration might be neurogenic origin. We consider that our case supports the latter hypothesis. In our case, the lingual swelling was aggravated for four consecutive days following the operation and then began to improve rapidly. The swelling resolved completely after 4 weeks. Glyceol and methylprednisolone sodium succinate were administered in an attempt to decrease the lingual swelling. But these drugs did not effectively minimize the swelling. It seemed that the lingual swelling resolved spontaneously. If macroglossia following posterior fossa exploration can be caused by abnormal autonomic nervous system discharges, stellate ganglion block, glossopharyngeal nerve block or vagus nerve block is thought to be indicated as treatment for the lingual swelling.
Aneurysm↗
Macroglossia: clinical considerations.
Macroglossia is a multifactorial condition that is almost always associated with a space-occupying mass of the tongue. The usual treatment is surgical resection. The typical medical conditions that lead to macroglossia have been described. The orofacial myologist should be alert to the presence of possible pathology of the tongue during orofacial examination, and refer suspected instances of macroglossia to an appropriate medical resource for definitive diagnosis and treatment.
Humans↗