The tongue is an important organ that occupies a large area in the oral cavity covering the floor of the mouth. It is below the palate, and is surrounded by teeth on either side. Together with the palate, it performs the function of swallowing. It is rightly said that the tongue is a gateway to the esophagus.
A host of things can go wrong with the formation of the tongue, since it develops from multiple sources, rather than a single progenitor process. Most of the developmental disturbances of the tongue are related to its size and shape, though structural defects also exist.
Defects related to the size of the tongue
This is a condition where the size of the tongue is abnormally small. Cases of complete absence of the tongue have been reported. Fortunately, it is a rare condition. Obviously, a tiny tongue will pose many difficulties related to speech and swallowing. There is no treatment for this condition, and the affected person will have to train their tongue to the best of their abilities.
This is a much more common condition than microglossia, where the tongue is highly enlarged. An enlarged tongue may be congenital, when it is associated with generalized muscular hypertrophy or hemi hypertrophy. Secondary macroglossia is that condition that occurs in conjunction with some other conditions like a tumor of the tongue, hemangioma and acromegaly. Acromegaly is a hormonal disturbance where growth hormone is secreted in excess of the requirements of the body. The reason behind the enlargement of the tongue in this case is related to the relaxation of the muscles that support the lower jaw, and there is no support to keep the tongue in position.
As a rule, macroglossia causes disturbances in the teeth as well. Due to the continuous pressure exerted by the heavy tongue, teeth begin to move away and the tongue occupies these spaces between the teeth, giving it a scalloped appearance.
Macroglossia is a prominent feature in Beckwith's hypoglycemic syndrome, where neonatal hypoglycemic predominates along with umbilical hernia and post-natal gigantism.
The treatment of macroglossia involves the removal of the cause that gives rise to this condition. At times, surgical stripping of the tongue to reduce the heavy musculature is also warranted.
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