Oral Medicine & Pathology

Macroglossia: Causes, signs & symptoms, Treatment

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.




(( 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.