Macroglossia Associated with Lymphangioma: Surgical Management of An Interesting Case

Abstract

A 15-year-old young boy was referred to the Department of Oral and Maxillofacial Surgery, KM Shah Dental College and Hospital, Vadodara, with a chief complaint of protrusion and increase in size of the tongue [Table /Fig-1a,b]. The patient was relatively asymptomatic and gave a history of trauma while playing in the ground 8 years back and resulted in injury to permanent lower incisors and a cut/ nick on the tongue. Patient was immediately taken to a local hospital and was treated by suturing. Since then, the patient complains of increased in size with protrusion of tongue. Patient did not have any history of dysphagia, stridor, respiratory distress, nasal obstruction, nasal discharge or bleeding. Sleep and diet were normal. On examination, a diffusely enlarged tongue [Table/ Fig-2] associated with anterior open bite was evident on palpation, the swelling was soft, non-tender and pebbly. The mouth opening was normal and there was slight restricted tongue movements. The speech was some what affected with open bite and incompetent lips mainly the lower lip. Hard tissue examination showed over-angulation of lower incisors with flattening of the alveolar ridge. A complete pre-operative blood analyses were within normal limits. ECG and chest X-ray were performed and appeared normal. A thorough history and physical examination were performed for congenital abnormalities such as Beckwith-Wiedemann syndrome, hypothyroidism commonly associated with macroglossia as one component.