Anterior Tongue Microglossia: Impact on Face Development

A cross-sectional study of tongue disorders among dental outpatients

PURPOSE

The tongue is a complex organ that can provide insight into oral and systemic conditions. A variety of disorders, such as geographic tongue, hairy tongue, fissured tongue, macroglossia, microglossia, and others, can be observed. The objective of this cross-sectional study, conducted on a cohort of dental patients, was to examine the prevalence of tongue disorders and their relationship with factors such as demographic data, oral hygiene practices, history of systemic diseases, and bad habits.

METHOD

The tongues of 772 dental outpatients, comprising 355 males and 417 females, were examined in detail, and the factors associated with tongue disorders were noted.

RESULTS

The prevalence of tongue disorders was 32.6 %. The remaining tongue disorders were as follows: fissured tongue (12.1 %), macroglossia (7.1 %), geographic tongue (3.4 %), hairy tongue (3.6 %), coated tongue (3.4 %), median rhomboid glossitis (0.5 %), ankyloglossia (0.4 %), glossitis (0.4 %), and microglossia (0.1 %). The most prevalent tongue disorder observed in the study cohort was fissured tongue, while both bifid tongue and idiopathic burning tongue syndrome were absent. The prevalence of macroglossia, fissured tongue, and hairy tongue was significantly higher in males than in females (p < 0.05, p < 0.05, p < 0.05, p < 0.005, respectively). A statistically significant difference was observed in the frequency of macroglossia, furred tongue, hairy tongue, and glossitis between age groups.

CONCLUSION

The findings of this study identified the most common tongue disorders and their relationship with factors such as systemic history, demographic factors, oral hygiene care, bad habits, and systemic diseases. The significance of tongue appearance in providing insight into the systemic and oral condition of the patient has once again been demonstrated.

Fetal Micro and Macroglossia: Defining Normal Fetal Tongue Size

OBJECTIVES

Abnormal fetal tongue size is a phenotypic feature of various syndromes including Beckwith-Wiedemann, Pierre-Robin, oromandibular limb hypoplasia, chromosomal aberrations, etc. Current data regarding normal fetal tongue size are limited. Hence, micro/macroglossia are subjectively determined. The aim of the study was to construct a contemporary fetal tongue nomogram and to assess its clinical contribution.

METHODS

A prospective cross-sectional study was performed in well dated, low risk, singleton pregnancies. Fetal tongues were measured by 5 trained sonographers. Highest quality images were selected. Intra- and interobserver variability was assessed. Tongue length, width, area, and circumference 1st to 99th centiles were calculated for each gestational week. Based on the normal tongue size charts, we created a Tongue Centile Calculator.

RESULTS

Over 18 months, 664 tongue measurements were performed. A cubic polynomial regression model best described the correlation between tongue size and gestational age. The correlation coefficient (r² ) was 0.934, 0.932, 0.925, and 0.953 for tongue length, width, area, and circumference, respectively (P < .001). Intra- and interobserver variability had high interclass correlation coefficients (>0.9). Using the new charts, we were able to identify 2 cases of macroglossia, subsequently diagnosed with Beckwith-Wiedemann, and 4 cases of microglossia, 3 associated with Pierre-Robin sequence, and 1 associated with persistent buccopharyngeal membrane.

CONCLUSIONS

We present novel fetal tongue size charts from 13 to 40 weeks of gestation. Clinical application of these nomograms may be beneficial in the prenatal diagnosis of syndromes or malformations associated with abnormal fetal tongue size.

Type IA Oromandibular-Limb Hypogenesis Syndrome: A Case Report and A Case Update

Hypoglossia is a rare congenital anomaly resulting in a small rudimentary tongue. It is classified under the oromandibular-limb hypogenesis syndrome and can be found in isolation (Type IA) but is more often associated with other congenital disorders, such as limb defects. Isolated hypoglossia cases are rare, and while feeding disorders are common, in some cases, neonatal airway obstruction is the most problematic. In the present report, we discuss two cases of newborns presenting with hypoglossia without limb deformities or visceral anomalies: one new case and a 10-year update of a previously reported case. These two cases highlight the variability in presenting symptoms and the challenges in diagnosis and management of a rare clinical entity. We focus on the discussion of early diagnosis, multidisciplinary management, and shared decision-making, with emphasis on the current therapeutic strategies available to the clinician and their limitations during the neonatal period. Early surgical multivector mandibular distraction osteogenesis can be proposed with minimal short- and long-term morbidity, pending a consistent follow-up. This clinical entity will require multidisciplinary team care into adult years.