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Muller JN, Shetye PR, Flores RL. LeFort III/I for Beckwith-Wiedemann Syndrome: A Case Report. Cleft Palate Craniofac J 2023; 60:1342-1347. [PMID: 35575244 DOI: 10.1177/10556656221101776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This case presents a facially mature patient with Beckwith-Wiedemann Syndrome (BWS) who presented with severe class III malocclusion. Computed tomography imaging revealed an anterior crossbite of 19 mm and a narrow pharyngeal airway at the level of the tongue base precluding mandibular setback surgery. The patient was indicated for a LeFort III combined with a LeFort I advancement, each of 10 mm, for a 20 mm combined advancement. Stable, functional occlusion was achieved without airway compromise. This novel use of the combined LeFort III/I can restore stable class I occlusion in patients with BWS at risk for tongue base airway compromise.
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Aflah KA, Yohana W, Oscandar F. Volumetric measurement of the tongue and oral cavity with cone-beam computed tomography: A systematic review. Imaging Sci Dent 2022; 52:333-342. [PMID: 36605855 PMCID: PMC9807796 DOI: 10.5624/isd.20220067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 01/07/2023] Open
Abstract
Purpose The goal of this systematic review was to compare the use of cone-beam computed tomography (CBCT) with that of computed tomography (CT) for volumetric evaluations of the tongue and oral cavity. Materials and Methods A search for articles was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines. The PubMed, Scopus, ScienceDirect, and SAGE Journals databases were searched for articles published between 2011 and 2021. Articles were screened and assessed for eligibility. Screening involved checking for duplication, reading the title and abstract, and reading the full text. Results The initial search retrieved 25,780 articles. Application of the eligibility criteria yielded 16 articles for qualitative analysis. Multiple uses of CBCT were identified. In several studies, researchers assessed the volumetric correlation between tongue and oral cavity volumes, as well as other parameters. Post-treatment volumetric evaluations of the oral cavity were also reported, and the reliability of CBCT was assessed. The use of CT resembled that of CBCT. Conclusion CBCT has been used in the evaluation of tongue and oral cavity volumes to assess correlations between those volumes and with the upper airway. It has also been used for volumetric evaluation after surgical and non-surgical procedures and to assess the relationships between tongue volume, tooth position, occlusion, and body mass index. Participants with obstructive sleep apnea and malocclusion have been evaluated, and the reliability of CBCT has been assessed. In the included studies, CT was utilized for similar purposes as CBCT, but its reliability was not assessed.
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Affiliation(s)
| | - Winny Yohana
- Department of Oral Biology, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Fahmi Oscandar
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
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Chen J, Xu Y, Li C, Zhang L, Yi F, Lu Y. Displacement and stress distribution of the craniomaxillofacial complex under different surgical conditions: a three-dimensional finite element analysis of fracture mechanics. BMC Oral Health 2021; 21:596. [PMID: 34809636 PMCID: PMC8607715 DOI: 10.1186/s12903-021-01941-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To provide a simplified treatment strategy for patients with maxillary transverse deficiency. We investigated and compared the fracture mechanics and stress distribution of a midline palatal suture under dynamic loads during surgically-assisted rapid palatal expansion. Methods Based on the cone-beam computed tomography (CBCT) data of a 21-year-old female volunteer, a three-dimensional model of the cranio-maxillofacial complex (including the palatal suture) was constructed. A finite element analysis model was constructed based on meshwork. After the yield strength of the palatal suture was set, an increasing expansion force (0–500 N) was applied within 140 ms to calculate the time–load curve, which mimicked nonsurgical bone expansion (model A). The same method was used to evaluate the fracture process, time and stress distribution of the palatal suture in maxillary lateral osteotomy-assisted (model B) and LeFort osteomy I (LFIO)-assisted expansion of the maxillary arch (model C).
Results Compared with model A, the palatal suture of model B and model C showed a faster stress accumulation rate and shorter fracture time, and the fracture time of model B and model C was almost identical. Compared with model A, we discovered that model B and model C showed greater lateral extension of the maxilla, and the difference was reflected mainly in the lower part of the maxilla, and there was no difference between model B and model C in lateral extension of the maxilla. Conclusions Compared with arch expansion using nonsurgical assistance (model A), arch expansion using maxillary lateral wall-osteotomy (model B) or LFIO had a faster rate of stress accumulation, shorter time of fracture of the palatal suture and increased lateral displacement of the maxilla. Compared with arch expansion using LFIO (model C), arch expansion using lateral osteotomy (model B) had a similar duration of palatal suture rupture and lateral maxillary extension. In view of the trauma and serious complications associated with LFIO, maxillary lateral wall-osteotomy could be considered a substitute for LFIO.
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Affiliation(s)
- Junjie Chen
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Hunan, 410008, Changsha, China
| | - Yuhan Xu
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Hunan, 410008, Changsha, China
| | - Chengri Li
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Hunan, 410008, Changsha, China
| | - Lingling Zhang
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Hunan, 410008, Changsha, China
| | - Fang Yi
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Hunan, 410008, Changsha, China
| | - Yanqin Lu
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Hunan, 410008, Changsha, China.
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Rajkumar B, Parameswaran R, Parameswaran A, Vijayalakshmi D. Evaluation of volume change in oral cavity proper before and after mandibular advancement. Angle Orthod 2021; 91:81-87. [PMID: 33289782 DOI: 10.2319/052420-474.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate the tongue and oral cavity proper volume in pre- and post-bilateral sagittal split osteotomy (BSSO) patients, and to establish whether there was a correlation between them. MATERIALS AND METHODS A retrospective study that evaluated 12 patients' pre- and post-surgical computed tomography records satisfying the inclusion criteria. Borders were defined for measurement of tongue and oral cavity proper volume. The volume assessment was carried out using 3D slice software. RESULTS The mean difference of tongue volume was 5.7 ± 1.7 cm3, which showed high statistical significance. The mean difference of oral cavity proper volume (OCVP) was 6.9 ± 3.4 cm3 and indicated high statistical significance. A very strong positive correlation existed between pre- and post-surgical tongue volume. Positive correlation was also evident between pre and post - surgical OCVP. Medium positive correlation was noted when the difference between pre- and post-surgical tongue and OCVP were assessed. CONCLUSIONS There was a significant change in volume of tongue and oral cavity proper after BSSO advancement surgery. The space around the tongue, position of tongue, and maxillary and mandibular relationship influence the volume of tongue and oral cavity proper.
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Meazzini MC, Besana M, Tortora C, Cohen N, Rezzonico A, Ferrari M, Autelitano L. Long-term longitudinal evalutation of mandibular growth in patients with Beckwith-Wiedemann Syndrome treated and not treated with glossectomy. J Craniomaxillofac Surg 2020; 48:1126-1131. [PMID: 33087311 DOI: 10.1016/j.jcms.2020.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/13/2020] [Accepted: 09/07/2020] [Indexed: 11/30/2022] Open
Abstract
AIM This study compares long-term mandibular growth between a group of Beckwith-Wiedemann Syndrome (BWS) patients who underwent glossectomy at an early age and a group of patients not operated. METHODS Cephalometric measurements were performed in BWS patients comparing the data obtained between a group of patients operated at an early age and a group of non-operated patients who declined surgery. Statistics included independent sample T-test. RESULTS Twenty-four out of 78 BWS patients followed since birth completed longitudinal cephalometric x-rays at age 5, 10 and 15. Eighteen patients needed early surgery. Eleven families accepted glossectomy at 2.3 ± 1.3 years of age; seven declined surgery. No differences in mandibular growth were found between the two groups. Inclination of maxillary incisors results were statistically greater in the non-operated group (operated compared to the non-operated group: 103.58 ± 11.30 Vs 108.98 ± 12.47; p-value 0.0168 at 5; 107.06 ± 7.98 Vs 115.14 ± 7.05; p-value 0.0206 at 10; 109.80 ± 4.68 Vs 116.75 ± 5.28; p-value 0.0233 at 15). CONCLUSION Macroglossia has no role in the post-natal mandibular overgrowth in BWS and mandibular overgrowth is part of the syndrome. Therefore, early glossectomy does not change mandibular growth and does not prevent the development of class III skeletal malocclusion in these patients.
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Affiliation(s)
- Maria Costanza Meazzini
- University of Milan, Smile House, Regional Center for CLP, Department of Maxillo-Facial Surgery, Santi Paolo and Carlo Hospital, Via di Rudinì 8, 20142, Milan, Italy; San Gerardo Hospital, Monza, Italy.
| | - Melissa Besana
- University of Milan, Smile House, Regional Center for CLP, Department of Maxillo-Facial Surgery, Santi Paolo and Carlo Hospital, Via di Rudinì 8, 20142, Milan, Italy; San Gerardo Hospital, Monza, Italy.
| | - Chiara Tortora
- University of Milan, Smile House, Regional Center for CLP, Department of Maxillo-Facial Surgery, Santi Paolo and Carlo Hospital, Via di Rudinì 8, 20142, Milan, Italy.
| | - Noah Cohen
- University of Milan, Smile House, Regional Center for CLP, Department of Maxillo-Facial Surgery, Santi Paolo and Carlo Hospital, Via di Rudinì 8, 20142, Milan, Italy.
| | - Angela Rezzonico
- University of Milan, Smile House, Regional Center for CLP, Department of Maxillo-Facial Surgery, Santi Paolo and Carlo Hospital, Via di Rudinì 8, 20142, Milan, Italy.
| | - Mario Ferrari
- University of Milan, Smile House, Regional Center for CLP, Department of Maxillo-Facial Surgery, Santi Paolo and Carlo Hospital, Via di Rudinì 8, 20142, Milan, Italy.
| | - Luca Autelitano
- University of Milan, Smile House, Regional Center for CLP, Department of Maxillo-Facial Surgery, Santi Paolo and Carlo Hospital, Via di Rudinì 8, 20142, Milan, Italy.
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The Utility of Early Tongue Reduction Surgery for Macroglossia in Beckwith-Wiedemann Syndrome. Plast Reconstr Surg 2020; 145:803e-813e. [PMID: 32221229 DOI: 10.1097/prs.0000000000006673] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Macroglossia, a cardinal feature of the (epi)genetic disorder Beckwith-Wiedemann syndrome, is associated with obstructive sleep apnea, speech and/or feeding difficulties, and dental or jaw malalignment. These sequelae may be treated and/or prevented with tongue reduction surgery; the authors sought to determine whether certain Beckwith-Wiedemann syndrome patients may benefit from early surgical intervention before age 12 months. METHODS The authors conducted a retrospective review of patients with Beckwith-Wiedemann syndrome who underwent tongue reduction from 2014 to 2019. The authors assessed primary outcomes of change in obstructive sleep apnea by polysomnography, respiratory support required, and feeding route before and after tongue reduction, and reviewed postoperative complications and the need for repeated tongue reduction. RESULTS Of the 36 patients included, the median age at tongue reduction was 9.5 months (interquartile range, 3.8 to 22.8 months). For those with severe obstructive sleep apnea, there was a significant reduction in the obstructive apnea hypopnea index from 30.9 ± 21.8 per hour to 10.0 ± 18.3 per hour (p =0.019) and improvement in nadir oxyhemoglobin saturation from 72 ± 10 percent to 83 ± 6 percent (p =0.008). Although there was no significant change in overall supplemental feeding tube or respiratory support, there were specific patients who experienced clinically meaningful improvement. Of note, these positive outcomes applied equally to those who underwent surgery at a younger age (<12 months). To date, only one patient required a repeated tongue reduction. CONCLUSION Based on improved polysomnographic findings and rarity of surgical complications or repeated surgery, the authors' data support the safety and efficacy of this early intervention when clinical indications are present and an experienced multidisciplinary team is available for consultation. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Marques P, Korbonits M. Pseudoacromegaly. Front Neuroendocrinol 2019; 52:113-143. [PMID: 30448536 DOI: 10.1016/j.yfrne.2018.11.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 10/30/2018] [Accepted: 11/14/2018] [Indexed: 01/19/2023]
Abstract
Individuals with acromegaloid physical appearance or tall stature may be referred to endocrinologists to exclude growth hormone (GH) excess. While some of these subjects could be healthy individuals with normal variants of growth or physical traits, others will have acromegaly or pituitary gigantism, which are, in general, straightforward diagnoses upon assessment of the GH/IGF-1 axis. However, some patients with physical features resembling acromegaly - usually affecting the face and extremities -, or gigantism - accelerated growth/tall stature - will have no abnormalities in the GH axis. This scenario is termed pseudoacromegaly, and its correct diagnosis can be challenging due to the rarity and variability of these conditions, as well as due to significant overlap in their characteristics. In this review we aim to provide a comprehensive overview of pseudoacromegaly conditions, highlighting their similarities and differences with acromegaly and pituitary gigantism, to aid physicians with the diagnosis of patients with pseudoacromegaly.
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Affiliation(s)
- Pedro Marques
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Márta Korbonits
- Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.
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Naujokat H, Möller B, Terheyden H, Birkenfeld F, Caliebe D, Krause MF, Fischer-Brandies H, Wiltfang J. Tongue reduction in Beckwith-Wiedemann syndrome: outcome and treatment algorithm. Int J Oral Maxillofac Surg 2018; 48:9-16. [PMID: 30057238 DOI: 10.1016/j.ijom.2018.07.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/30/2018] [Accepted: 07/11/2018] [Indexed: 11/27/2022]
Abstract
Beckwith-Wiedemann syndrome is a rare congenital overgrowth disorder with macroglossia being one of the cardinal symptoms. In pronounced cases, macroglossia can lead to airway obstruction, musculoskeletal alterations and functional deficits. Surgical tongue reduction is performed at varying ages and with different techniques. This study evaluated perioperative complications, as well as long-term aesthetic and functional outcomes, in a large cohort. A total of 68 patients, treated either surgically or conservatively, were included. Depending on the severity of macroglossia, patients were divided into three groups to determine the treatment algorithm. Complications after surgical tongue reduction were prolonged intubation and revision due to dehiscence or haematoma. In the long term, no patient suffered from impaired sense of taste or paresthesia, although the shape of the tongue was disproportional in 85%. With the present treatment algorithm, operative tongue reduction exerts a positive influence on skeletal, dentoalveolar and functional development with sufficient long-term outcome and high grade of satisfaction of the patients. Supportive therapy in an interdisciplinary centre is of fundamental importance for both surgical and conservative treatment.
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Affiliation(s)
- H Naujokat
- Departments of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
| | - B Möller
- Departments of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - H Terheyden
- Departments of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - F Birkenfeld
- Departments of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - D Caliebe
- Departments of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - M F Krause
- Departments of Pediatrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - H Fischer-Brandies
- Departments of Orthodontics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - J Wiltfang
- Departments of Oral and Maxillofacial Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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Ding X, Suzuki S, Shiga M, Ohbayashi N, Kurabayashi T, Moriyama K. Evaluation of tongue volume and oral cavity capacity using cone-beam computed tomography. Odontology 2018; 106:266-273. [PMID: 29468332 PMCID: PMC5996000 DOI: 10.1007/s10266-017-0335-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 10/22/2017] [Indexed: 12/19/2022]
Abstract
The aims of this study were to reveal the usefulness of a newly developed method for measuring tongue volume (TV) and oral cavity capacity (OCC) and to assess the relationship between them. The tongue was coated with a contrast agent, and the TV and OCC were determined using cone-beam computed tomography (CBCT). We enrolled 20 adults who were scheduled to undergo CBCT to evaluate the relationship of the third molar roots to the alveolar nerve before molar extraction. Each participant’s tongue was coated with a contrast agent, and CBCT of the tongue and oral cavity was performed. Using computer software, we evaluated reconstructed 3D images of the TV, oral cavity proper volume (OCPV), and OCC. The mean TV was 47.07 ± 7.08 cm3. The mean OCPV and OCC were 4.40 ± 2.78 cm3 and 51.47 ± 6.46 cm3, respectively. There was a significant correlation between TV and OCC (r = 0.920; p < 0.01) but not between TV and OCPV. The mean TV/OCC ratio was 91 ± 5%. The proposed method produced CBCT images that enabled effective measurement of TV and OCC. This simple method of measuring TV and OCC will be useful in the diagnosis on the tongues with abnormal size.
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Affiliation(s)
- Xuefang Ding
- Department of Stomatology, Beijing Jishuitan Hospital, Beijing, China.,Maxillofacial Orthognathics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shoichi Suzuki
- Maxillofacial Orthognathics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Momotoshi Shiga
- Division of Orofacial Functions and Orthodontics, Kyushu Dental University, Kitakyushu-shi, Fukuoka-ken, Japan
| | - Naoto Ohbayashi
- Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toru Kurabayashi
- Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiji Moriyama
- Maxillofacial Orthognathics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
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Núñez-Martínez PM, García-Delgado C, Morán-Barroso VF, Jasso-Gutiérrez L. [Congenital macroglossia: clinical features and therapeutic strategies in paediatric patients]. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2016; 73:212-216. [PMID: 29421209 DOI: 10.1016/j.bmhimx.2016.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 03/25/2016] [Indexed: 11/29/2022] Open
Abstract
Congenital macroglossia is a condition that consists in an enlarged tongue that in resting position protrudes beyond the alveolar ridge. It has been classified in two categories: true macroglossia, which occurs in congenital or acquired forms, and relative macroglossia. As this alteration may be due to different causes, its incidence is not known. It is more frequently associated to Beckwith-Wiedemann syndrome, to mucopolysaccharidosis diseases and to Pompe's disease, and it has been less frequently associated to lymphangioma, hemangioma or isolated muscular hypertrophy. Macroglossia is characterized by an enlarged and thick tongue that may have fissures and ulcers, may cause language alterations, difficulties for feeding and swallowing, sialorrhea and recurrent infections of the upper airway or even its obstruction. Its clinical evaluation must include a complete clinical chart with careful physical exploration and a pedigree of that may identify the presence or absence of a hereditary associated syndrome. Macroglossia management is complex. More than twenty different surgical options to reduce the tongue size have been proposed, however, so far there is not a general agreement in this respect. The objective of this work is to review clinical and surgical aspects related to macroglossia from the point of view of non-surgical pediatricians and genetists, addressed to the different medical specialists, including the maxillofacial surgeons involved in the management of these patients.
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Affiliation(s)
| | | | | | - Luis Jasso-Gutiérrez
- Departamento de evaluación y análisis de medicamentos, Hospital Infantil de México Federico Gómez, Ciudad de México, México.
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