Surgical management of macroglossia: discussion of 7 cases

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".

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.

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.

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.