What is Macroglossia?

The term macroglossia refers to an enlarged tongue. The condition has numerous causes and is most commonly seen in children and young adults. Macroglossia is usually diagnosed based on the appearance of the tongue.

Another condition - pseudomacroglossia - refers to a condition where the tongue is actually of a normal size but appears large due to other anatomical factors such as a small mandible.

Why is macroglossia a problem?

Macroglossia may lead to several complications such as:

  • Breathing difficulties, especially in young children
  • Difficulty in breathing and snoring during sleep
  • Speech problems
  • Difficulty in chewing, swallowing and eating
  • Increased size of the lower jaw
  • Increased spacing between teeth
  • Tooth malpositioning or crooked teeth arrangements
  • Crinkling of the tongue at the sides due to pressure from the teeth. This is called "pie crust tongue"
  • Orthodontic abnormalities
  • Tongue sores and mouth infections
  • Excess salivation or drooling
  • Sores at the sides of the mouth
  • Mouth breathing (rather than nasal), leading to drying of the mouth

Causes of macroglossia

Macroglossia may be caused by:

  • Tumors of the tongue
  • Muscle enlargement of the tongue, as seen in Beckwith-Weidemann syndrome
  • Malformations or swellings of the blood vessels within the tongue called lymphangiomas or hemangiomas
  • Down syndrome
  • Amyloidosis
  • Mucopolysaccharoidosis
  • Myxedema and underactive thyroid function
  • Acromegaly or over production of growth hormone
  • Neurofibromatosis
  • Allergies or angioedema
  • Lingual thyroid gland present in the tongue
  • Transient neonatal diabetes

Diagnosis and treatment

Diagnosis is most commonly made on clinical examination of the tongue. Possible causes of macroglossia need to be explored using blood tests and imaging studies. Treatment depends on the severity of the condition and its associated problems. Mild cases where there are little or no symptoms may not require treatment.

By contrast, individuals with significant symptoms may require surgery to reduce the size of the tongue, a procedure called glossectomy. Orthodontic therapy may be required to correct crooked teeth.

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