title: Anterior tongue reduction surgery for paediatric macroglossia.
abstract: OBJECTIVE
  Anterior tongue reduction is indicated when macroglossia causes problems with oral hygiene, airway compromise, deglutition, articulation or orthognathic complications. Causes of macroglossia include hypothyroidism, mucopolysaccharide and lipid storage disease, lymphangioma, haemangioma, neurofibroma, and muscular macroglossia. This paper presents an 11-year experience of anterior tongue reduction at Great Ormond Street Hospital.
  
  
  METHODS
  Retrospective study of patient medical records identified from the hospital ENT database. Anterior wedge resection was the preferred technique.
  
  
  RESULTS
  Anterior tongue reduction was performed on 18 patients, due to cystic hygroma with tongue involvement (nine patients), Beckwith-Wiedemann syndrome (eight) and Down's syndrome (one). Anterior wedge resection was preferred, using electrocautery in the majority, except for four cases involving CO2 laser. All but one patient had a good surgical outcome (i.e. tongue in mouth at rest). One patient subsequently required multiple laser procedures for recurrent macroglossia.
  
  
  CONCLUSIONS
  Anterior tongue reduction can be a safe procedure, with limited post-operative morbidity, consistently resulting in good surgical outcomes and improvement in macroglossia symptoms. Speech development does not appear to be adversely affected.
authors.affiliation: Great Ormond Street Hospital, London, UK. hanychau@hotmail.com
authors.forename: H
authors.initials: H
authors.lastname: Chau
authors.forename: M
authors.initials: M
authors.lastname: Soma
authors.forename: S
authors.initials: S
authors.lastname: Massey
authors.forename: R
authors.initials: R
authors.lastname: Hewitt
authors.forename: B
authors.initials: B
authors.lastname: Hartley
mesh_terms: D001506:Beckwith-Wiedemann Syndrome / Q000150:complications*; D002648:Child; D004564:Electrocoagulation; D005927:Glossectomy / Q000379:methods*; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D018191:Lymphangioma, Cystic / Q000473:pathology / Q000601:surgery*; D008260:Macroglossia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013536:Suture Techniques; D014062:Tongue Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome