Definition of Macroglossia:
– it’s tongue enlargement which leads to functional problems & sometimes to death.
– the functional problems include:
1) swallowing problem.
2 ) speech problem.
Classification of Macroglossia:
1) Congenital or acquired.
2 ) Relative or Apparent:
– Relative Macroglossia: this is normal sized tongue within a small oral cavity.
– Apparent Macroglossia: this is a large sized tongue due to poor muscular control.
Causes of Macroglossia:
(1) Congenital causes:
– The congenital disorders that cause macroglossia include hemangioma, lymphangioma, cretinism, Down Syndrome.
(2) Neoplastic causes:
– Malignant tumor such as carcinoma & sarcoma.
– Benign tumor such as neurofibroma, granular cell tumor, and lipoma.
(3) Inflammatory Causes:
– includes T.B, dental infection, ranula, calculus.
(4) Metabolic Causes:
– This includes acromegaly, myxedema, amyloidosis, chronic steroid therapy.
(5) Muscular Causes:
– This is due to over development of musculature of the tongue.
(6) Traumatic Causes:
– such as Postoperative Edema, Hematoma.
Clinical Features of Macroglossia:
A- Symptoms:
– The patient suffers from:
1) Difficulty in breathing.
2) Difficulty in eating.
3) Difficulty in speech.
4) Drooling of saliva from the mouth.
5) Infection in the upper respiratory tract.
B- Signs:
– The Dentist will observe the following:
1) Malocclusion: due to hyperactivity of tongue muscle which leads to pressure over the teeth.
2) Scalloping of the tongue: which fits the interproximal spaces between teeth.
3) Maybe associated with syndrome such as Beckwith’s syndrome
C – Affected Age:
– It’s more common in young age especially infants.
– less common in the old age as the hyoid bone descends with age.
Diagnosis of Macroglossia:
– by inspection of the large size of the tongue.
Management & Treatment of Macroglossia:
1) Restore the normal muscular tone using a palatal device.
2) Surgical Intervention:
– Indicated in case of airway obstruction, speech difficulty, dysphagia.
3) Orthodontic Intervention:
– to correct the malocclusion that occurred by macroglossia.
4) speech correction through speech therapy.
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(( Beckwith’s syndrome )) :
– It’s a rare genetic overgrowth disorder characterized by:
a- increased weight after birth.
b- macroglossia.
C- visceromegaly: enlargement of the viscera
d- abdominal wall defect.
E- hypoglycemia.
F- an abnormal size of one side of the body.