Developmental severe macroglossia. management and surgical treatment of a difficult case

ABSTRACT

Presented an extremely rare case of developmental Macroglassia in a female child with significant functional and cosmetic symptoms. The condition was worsening progressively despite persistent conservative treatment necessitating surgical management. Severe macroglassia is a rare condition, usually presents as an enlarged tongue causing not only the functional symptoms like airway, speech or dietary difficulties but also presents cosmetic and social issues. Such lesions are rare but well documented in the medical literature. Our case is a female patient who was asymptomatic by birth and thereafter, but started to have progressive increase in her tongue size at the age of two, with obstructive symptoms. The patient was initially treated by conservative therapy and other alternative minimally invasive modalities of treatment. After no significant improvement over a period of almost two years, the size kept on increasing and ultimately the massive size, the cosmetic and social stress necessitates the surgical option. The macroglossia was treated successfully by surgical excision relieving all the symptoms. Different aetiologies of the condition have been mentioned in the medical literature. The treatment depends on the diagnosis, the size, the location of the tongue involved and the symptoms caused by them. If the tongue is massively enlarged and the conservative treatment fails, the surgical excision is one of the best recommended treatment options