Macroglossia: etiologic considerations and management techniques

Tongue enlargement of varying degrees occurs in many people and often requires no therapy. However, marked tongue enlargement, when present, requires direct intervention. In this case, the otolaryngologist is presented with a dilemma, for the etiology of the problem is often obscure. In many cases, the tongue enlargement is secondary to systemic disease, and medical management is indicated. When tongue reduction is indicated, there are many modalities available. Of these, only excision offers an acceptable functional result with minimal morbidity. Even large protuberant tongues can be reduced with minimum difficulty. The type of tongue excision can be tailored to the involved area and to special patient requirements. The problem of macroglossia is explored and management techniques are reviewed to present an alternative for optimal management of the enlarged tongue.