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Management of MACROGLOSSIA: Case Series and Suggested Algorithm.

Joyce Xu1, Steven M Roser2, Vaidehi Avadhani3

  • 1Resident, Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|October 7, 2022
PubMed
Summary

Idiopathic macroglossia, a rare tongue enlargement, was studied in five patients. Surgical intervention including partial glossectomy led to improved function and quality of life in most cases.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Otolaryngology
  • Surgical Pathology

Background:

  • Idiopathic macroglossia is a rare condition characterized by unexplained tongue enlargement.
  • Limited case reports exist on the diagnosis and management of this condition.
  • This study addresses the scarcity of literature by presenting a patient series.

Purpose of the Study:

  • To present a series of patients diagnosed with idiopathic macroglossia.
  • To suggest a management algorithm for idiopathic macroglossia.
  • To analyze outcomes following surgical intervention.

Main Methods:

  • Retrospective case series of patients treated by Oral and Maxillofacial Surgery.
  • Analysis of medical comorbidities, clinical presentation, and radiographic findings.
  • Evaluation of outcomes including tongue size normalization, nutritional support, and tracheostomy status.

Main Results:

  • Five patients with a mean age of 45 years were included.
  • All patients developed macroglossia after prolonged oral intubation (average 3.5 weeks).
  • Surgical management (tracheostomy, PEG tube, partial glossectomy) resulted in successful outcomes in 80% of patients.

Conclusions:

  • The etiology of macroglossia in this cohort remained unclear.
  • Management involves initial stabilization with tracheostomy and feeding access, followed by glossectomy.
  • Surgical glossectomy improved tongue form, function, and quality of life.