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.
Surgical goals are to reduce the tongue size and produce improved function.
Good airway management is important in the postoperative period. For small children and infants this may be done with tracheotomy, and in older children prolonged intubation may be adequate. Different authors have advocated a number of different approaches for tongue reduction. Rather than using one approach, each case should be evaluated and the appropriate surgical approach chosen. Different resections provide reduction in different directions.