Reduction glossectomy for macroglossia in children

Abstract

Background/aim: Although several surgical techniques have been described for reduction glossectomy in children, many general pediatric surgeons are still skeptical about the treatment of patients with macroglossia because of potential surgical complications. The aim of this study was to describe our initial surgical experience with reduction glossectomy in a series of eight patients with macroglossia.

Materials and methods: A retrospective file review was carried out for all patients who underwent reduction glossectomy during the period from October 2009 to December 2014. Charts were designed to collect the following data from the patients’ files: age; etiology of macroglossia; and full clinical examination including the functional respiration, deglutition, phonation deficit, and dental occlusion alterations.

Results: The records of eight patients were retrieved. Five patients, in whom macroglossia affected the tongue width and length, underwent peripheral glossectomy, whereas two patients, in whom macroglossia affected the tongue in all directions, underwent key-hole glossectomy. In one patient in whom only half the tongue was affected, a central longitudinal strip was excised. Motor and sensory  functions, especially taste sensation, were not affected by resection. Speech articulation errors were corrected in cases that stared speech. One complication occurred in one patient who had undergone a key-hole glossectomy: wound infection, followed by partial wound disruption.

Conclusion: Partial glossectomy for macroglossia in children is both feasible and safe. It results in minimal complications. Many clinical problems caused by the pathology improve after surgery repair. The recommended surgical technique should be based on the extent of involvement of the tongue.

Keywords: Beckwith–Wiedemann syndrome, macroglossia, reduction glossectomy