J Korean Assoc Oral Maxillofac Surg.  2021 Jun;47(3):209-215. 10.5125/jkaoms.2021.47.3.209.

Functional outcomes in children with reduction glossectomy for vascular malformations – “less is more!”

• Thomas JK
• Gaikwad VS
• Babu TR
• Mathai J
• Srinivas R
• Karl IS

• KMID: 2517271
• DOI: http://doi.org/10.5125/jkaoms.2021.47.3.209

Abstract

Objectives
Vascular malformation (VM) of the tongue can cause true macroglossia in children. Reduction glossectomy provides primary relief when sclerotherapy has failed or is not possible. In this study, we evaluated the surgical role in functional outcome of reduction glossectomy performed for VM of the tongue.
Patients and Methods
We evaluated the functional and surgical outcomes of seven children who were treated at a tertiary care centre in Southern India between 2013 and 2018.
Results
Six children underwent median glossectomy, while one child underwent lateral glossectomy. Functional assessment was performed at least 2 years after the date of surgery. At the time of assessment, speech was comprehensible for three children and was occasionally unintelligible in four children. Taste and swallowing were normal in all seven children. Six children exhibited a minimal residual lesion after surgery, of which only one was symptomatic. Residual lesions were managed with sclerotherapy (n=3), observation (n=2), or repeat surgery (n=1).
Conclusion
Reduction glossectomy in children with macroglossia secondary to VMs has acceptable outcomes in terms of cosmesis and speech, with no gastronomic restriction.

Keyword

Macroglossia; Glossectomy; Vascular malformation; Treatment outcome; Sclerotherapy

Figure

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  Fig. 1 A. Clinical picture of Patient 1. B, C. Clinical pictures of Patient 2. Preoperative (B) and three weeks after surgery (C).

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  Fig. 2 Preoperative magnetic resonance imaging.

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  Fig. 3 A. Vascular lesion penetrating between skeletal muscle fibres displaying ecstatic venous (narrow arrows) and lymphatic channels (broad arrows) (H&E staining, ×100). B. Lymphangioma showing dilated lymphatic channels containing serous fluid (broad arrow) and stroma with lymphoid aggregates (narrow arrows) (H&E staining, ×100). C. D2-40 antibody showing positive immunoreaction for lymphatic endothelium and negative reaction for venous endothelium (IHC staining, ×100).

Reference

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