Macroglossia

Macroglossia, sometimes called giant tongue or enlarged tongue, is a rare condition that typically affects more children than adults. People with macroglossia have tongues that are larger than typical, given the size of their mouths. Macroglossia is a rare condition.

Tongue

Symptoms

Macroglossia may cause nasopharyngeal obstruction, leading to total obstruction of the airway and subsequently, cerebral anoxia and sudden cardiac arrest. Other symptoms include drooling, swallowing difficulties, airway obstruction, mandibular deformities, teeth spacing abnormalities, and failure to thrive. Due to abnormal size and position, patients may suffer from speech and articulation problems. Macroglossia makes intubation difficult, and care should be taken as blind intubation may result in trauma.

Etiology

Macroglossia is usually seen in association with genetic syndromes. Macroglossia can be congenital or acquired. Most people are born with macroglossia that can be linked to conditions such as Beckwith-Wiedemann syndrome or Down syndrome. Patients with Down syndrome present with a short neck, hypotonia, a tongue that tends to stick out more, small ears, and has distinctive facial features. People can also develop macroglossia from some forms of cancer or severe infections. Macroglossia is the most frequent oral manifestation of amyloidosis and maybe the only presenting symptom of the disease. Hypothyroidism is a common cause of macroglossia in children.

Blocked airway due to tongue

Treatment

Treatment for macroglossia varies depending on the underlying cause. Macroglossia treatments may include medication such as corticosteroids for swelling, orthodontic treatment or surgery. About 10% of people treated for macroglossia have surgery to reduce the size of their tongues. Corticosteroids can be used postoperatively to treat edema of the tongue and maybe life-saving in acute obstructions. Patients with acromegaly and macroglossia who do not respond to medical therapy may benefit from partial glossectomy.