Thyroid function tests are used to rule out hypothyroidism. Thyroid scan may identify a lingual thyroid. Patients with chronic airway obstruction may need CXR and EKG to evaluate right heart failure. Treatment options include observation, orofacial therapy, and surgery. Patients that have minimal symptoms may be observed since changes in tongue position may improve the disorder.
Orofacial therapy uses a palatal device to stimulate muscular tone and proper tongue position.
This is used in patients with Down Syndrome to counteract their hypotonia and improve their tongue position. Limbrock et al reported their results using orofacial therapy in a series of 89 patients with Down Syndrome. The majority of cases of macroglossia are treated surgically. Indications for surgery include airway obstruction, speech difficulties, dysphagia, and cosmetics. The procedure of choice is partial glossectomy.