MacroglossiaK14.8

Polyätiological, congenital or acquired clinical symptom defined by an acute or chronic, passagere or permanent, partial or total "enlargement of the tongue".

• Permanent macroglossia:
  • Vascular malformations (unshaped distension, soft, changing consistency)
  • Infant hemangioma (soft red tumor)
  • Lymphangioma (cavernous lymphangioma, deep-seated)
  • in the context of syndromes (rare):
    • Down syndrome (clinically groundbreaking overall aspect)
    • Mucopolysaccharidoses, hereditary
    • Beckwith-Wiedemann syndrome
    • Winchester syndrome.
• Temporary macroglossia:
  • acute:
    • Angioedema (highly acute)
    • Melkersson-Rosenthal syndrome ( Glossitis granulomatosa)
    • after trauma (cave: coagulopathies)
    • Tongue abscess (painful)
    • Tongue phlegmons (painful, general symptoms)
  • chronic:
    • Hyalinosis cutis et mucosae (clinical overall aspect leading the way)
    • Myxoedema (overall clinical aspect leading the way)
    • Acromegaly (acromegal body formation)
    • Amyloidosis (firm, bacon-like tongue, dumpy language)
    • Syphilis(Glossitis interstitialis profunda or Glossitis gummosa) (rare, laboratory)
    • Sarcoidosis (histologically clearable)
    • Actinomycosis (histologically clearable)
    • Glossitis Möller-Hunter (mirror-smooth train surface)
    • Tongue carcinoma (chronic, hard as a board).

Aetiopathogenetically, macroglossia can be caused by edema (e.g. angioedema), abscess formation (e.g. tongue abscess), deposits (e.g. amyloidosis) or new tissue formation (carcinoma of the tongue).

Depending on the cause, very different clinical pictures, which ultimately lead to an acute or chronic, transitory or permanent, complete or partial circumferential enlargement of the tongue of varying degrees. In cases of pronounced macroglossia, chewing and speaking difficulties (dumpy speech) occur; swallowing difficulties are also possible.

1. Elinav E et al (2004) Episodic macroglossia as the sole manifestation of angiotensin-converting enzyme inhibitor-induced angioedema. Ann Otol Rhinol Laryngol 113(3 Pt 1): 223-224
2. Guelmann M, Katz J (2003) Macroglossia combined with lymphangioma: a case report. J Clin Pediatr Dent 27: 167-169
3. Kruchinsky HV (1990) A new tongue reduction method. J Oral Maxillofac Surgery 48: 756-767
4. Mixter RC et al (1993) Central tongue reduction for macroglossia. Plast Reconstr Surgery 91: 1159-1162
5. Vogel JE et al (1986) Macroglossia: a review of the condition and a new classification. Plast Reconstr Surgery 78: 715-723