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Anterior tongue reduction surgery for paediatric macroglossia

Published online by Cambridge University Press:  14 September 2011

H Chau*
Affiliation:
Great Ormond Street Hospital, London, UK
M Soma
Affiliation:
Great Ormond Street Hospital, London, UK
S Massey
Affiliation:
Great Ormond Street Hospital, London, UK
R Hewitt
Affiliation:
Great Ormond Street Hospital, London, UK
B Hartley
Affiliation:
Great Ormond Street Hospital, London, UK
*
Address for correspondence: Mr Ha Chau, 111 Eton Hall, Eton College Road, London NW3 2DN, UK E-mail: hanychau@hotmail.com

Abstract

Objective:

Anterior tongue reduction is indicated when macroglossia causes problems with oral hygiene, airway compromise, deglutition, articulation or orthognathic complications. Causes of macroglossia include hypothyroidism, mucopolysaccharide and lipid storage disease, lymphangioma, haemangioma, neurofibroma, and muscular macroglossia. This paper presents an 11-year experience of anterior tongue reduction at Great Ormond Street Hospital.

Method:

Retrospective study of patient medical records identified from the hospital ENT database. Anterior wedge resection was the preferred technique.

Results:

Anterior tongue reduction was performed on 18 patients, due to cystic hygroma with tongue involvement (nine patients), Beckwith–Wiedemann syndrome (eight) and Down's syndrome (one). Anterior wedge resection was preferred, using electrocautery in the majority, except for four cases involving CO2 laser. All but one patient had a good surgical outcome (i.e. tongue in mouth at rest). One patient subsequently required multiple laser procedures for recurrent macroglossia.

Conclusion:

Anterior tongue reduction can be a safe procedure, with limited post-operative morbidity, consistently resulting in good surgical outcomes and improvement in macroglossia symptoms. Speech development does not appear to be adversely affected.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Giancotti, A, Romanini, G, Di Girolamo, R, Arcuri, C. A less invasive approach with orthodontic treatment in Beckwith-Wiedemann patients. Orthod Craniofac Res 2002;5:5963CrossRefGoogle ScholarPubMed
2Miyawaki, S, Oya, S, Noguchi, H, Takano-Yamamoto, T. Long-term changes in dentoskeletal pattern in a case with Beckwith-Wiedemann syndrome following tongue reduction and orthodontic treatment. Angle Orthod 2000;70:326–31Google Scholar
3Donaldson, JD, Redmond, WM. Surgical management of obstructive sleep apnoea in children with Down syndrome. J Otolaryngol 1988;17:398403Google ScholarPubMed
4Jacobs, IN, Gray, RF, Todd, NW. Upper airway obstruction in children with Down syndrome. Arch Otolaryngol Head Neck Surg 1996;122:945–50Google Scholar
5Sculerati, N, Gottieb, MD, Zimbler, MS, Chibbaro, PD, McCarthy, JG. Airway management in children with major craniofacial anomalies. Laryngoscope 1998;108:1806–12Google Scholar
6Rimell, FL, Shapiro, AM, Shoemaker, DL, Kenna, MA. Head and neck manifestations of Beckwith-Wiedemann syndrome. Otolaryngol Head Neck Surg 1995;113:262–5Google Scholar
7Potsic, , Cotton, , and Handler, . Surgical Pediatric Otolaryngology. Thieme: New York, 1996;251–3Google Scholar