Makroglossie

Makroglossie, or macroglossia in English, is a medical condition characterized by an abnormally enlarged tongue. The enlargement can be generalized or localized and may result from tissue overgrowth, infiltration by abnormal substances, or swelling. The term is used in various languages to describe a similar condition, and distinguishing true macroglossia from apparent swelling caused by surrounding tissues is important in evaluation.

Causes and classification

Macroglossia can be congenital or acquired. Common congenital associations include Beckwith-Wiedemann syndrome, Down syndrome, and congenital hypothyroidism. Acquired causes encompass systemic amyloidosis, acromegaly, lymphangioma or other vascular malformations, tumors or metastases invading the tongue, and inflammatory or vascular processes causing edema. Clinically, the tongue may be simply enlarged (true macroglossia) or appear enlarged due to edema or jaw/tacial abnormalities (pseudomacroglossia).

Symptoms and complications

Enlargement of the tongue can impair articulation, swallowing (dysphagia), and chewing, and may cause drooling. Severe cases can contribute to airway obstruction, sleep apnea, poor fit of dental appliances, or feeding difficulties in children. The specific symptoms often reflect the underlying cause as well as the functional impact of the tongue size.

Diagnosis

Assessment includes medical history, physical examination, and measurement of tongue size. Imaging studies such as MRI or CT can determine the extent and involvement of tissues. Endoscopy or biopsy may be used when tumors or infiltrative disease are suspected.

Treatment and prognosis

Management depends on the underlying cause and the severity of symptoms. Treating the primary condition is essential; when function is severely affected or there is airway compromise, surgical reduction of the tongue (partial glossectomy or debulking procedures) may be considered. Multidisciplinary care, including ENT, maxillofacial surgery, endocrinology, and genetics, is common. Prognosis varies with the cause; acquired macroglossia from systemic disease may have significant implications, while isolated, mild cases may have a favorable outcome with appropriate management.