ABSTRACT
Macroglossia is defined as a resting tongue that protrudes beyond the teeth, or in the case of the neonate, the alveolar ridge. Pseudomacroglossia arises when the tongue itself is normal but relative protrusion occurs because of a small mandible. Primary macroglossia can be due to an intralingual lesion such as lymphangioma, hemangioma, dermoid cyst, or hyperplasia associated with systemic disorders such as chromosomal abnormalities, hypothyroidism, amyloidosis, or simply may be idiopathic. Lymphangioma is the most common cause of macroglossia to present in the neonatal period, and prenatal diagnosis by ultrasound is possible when associated with Beckwith–Wiedemann syndrome and some of the intraoral cystic lesions. Mild macroglossia as seen in most children with Beckwith–Wiedemann syndrome and smaller oral lesions does not need any special care. Reduction glossectomy is the mainstay of treatment, and options include central wedge resection, circumferential wedge resection, or a combined transoral and transcervical approach for a massive infiltrative lymphangioma.
