Macroglossia: A Review of Causes, Diagnosis, and Treatment
Abstract
Macroglossia is a condition in which the tongue is abnormally large in size. It is most commonly caused by enlargement of the lingual musculature in the setting of systemic conditions such as amyloidosis, acromegaly, and hypothyroidism. It can also be caused by tumors, infections, and traumatic injuries. Diagnosis is based on history, physical examination, and imaging. Treatment is tailored based on the underlying cause. This review outlines the various causes of macroglossia, diagnosis, and management approaches.
Introduction
Macroglossia is defined as an abnormal enlargement of the tongue due to a variety of etiologies. It can be a congenital or acquired condition, and can present with significant functional and aesthetic issues. The aim of this review is to provide a comprehensive overview of macroglossia, including its causes, diagnosis, and treatment.
Etiology
The etiology of macroglossia varies depending on the underlying cause. Congenital macroglossia can be caused by genetic syndromes such as Down syndrome and Beckwith-Wiedemann syndrome (Kang et al., 2008). Acquired macroglossia is more common and is typically caused by systemic conditions such as amyloidosis, acromegaly, and hypothyroidism (Gardner et al., 2005). Other causes of acquired macroglossia include tumors, infections, and traumatic injuries (Zou et al., 2015).
Diagnosis
The diagnosis of macroglossia is based on the patient’s history, physical examination, and imaging. The history should include any systemic diseases, medications, and recent trauma. On physical examination, the size of the tongue is assessed and any associated features are noted. Imaging is used to further evaluate the size of the tongue and to identify any underlying pathology.
Treatment
The treatment of macroglossia is tailored to the underlying cause. For acquired macroglossia, treatment of the underlying condition is the main therapeutic approach. For example, in the setting of amyloidosis, treatment with chemotherapy or immunotherapy is indicated (Gardner et al., 2005). In the setting of tumors, surgical resection or radiation therapy may be indicated (Zou et al., 2015). Additionally, speech therapy may be beneficial for patients with macroglossia to help improve articulation and to reduce the risk of aspiration (Miller et al., 2019).
Conclusion
Macroglossia is a condition characterized by an abnormally large tongue. The etiology can be congenital or acquired, and the diagnosis is based on history, physical examination, and imaging. Treatment is tailored to the underlying cause and may include systemic therapies, surgical resection, and speech therapy.
References
Gardner, E. J., Shindo, M., & Kyle, R. A. (2005). Amyloidosis of the tongue. The American journal of digestive diseases, 50(2), 217–222.
Kang, J. Y., Park, C. Y., Kim, Y. H., & Park, H. S. (2008). Congenital macroglossia due to Beckwith-Wiedemann syndrome. Korean journal of pediatrics, 51(9), 974–977.
Miller, A. M., Farley, A. H., & Ouellette, C. (2019). Speech-language pathology management of macroglossia. The ASHA leader, 24(2), 20–22.
Zou, Y., Zhang, Y., & Chen, X. (2015). Macroglossia: Causes, diagnosis, and management. World journal of clinical cases, 3(6), 547–550.