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Improving Outcomes in Tongue Reduction Surgery
Sabine Lovell, MD; Logan Erz, MD; Aditya Sharma, BS; Niyant Patel, MD
Summa Health System / Akron Children's Hospital
2019-02-15
Presenter: Sabine Lovell
Affidavit:
Doug Wagner, MD
Director Name: Doug Wagner, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: Congenital macroglossia, a rare condition often associated with Beckwith-Wiedemann syndrome, can have negative social and functional implications. Multiple tongue reduction techniques have been described with variable results and a reported average hospital length of stay of 9.59 days.
Method: A retrospective review was performed on all pediatric patients who underwent a partial glossectomy by one surgeon between 2012 and 2019 at Akron Children's Hospital. A modified central wedge resection with tip preservation technique using a radiofrequency dissection device was performed. A nasogastric tube was placed intra-operatively since inadequate nutrition can be a barrier to discharge. Patients were discharged home when tolerating bolus tube feeds. We did comprehensive speech, airway, occlusion, oral competence and parental satisfaction evaluations.
Results: Eight patients met inclusion criteria and 62.5% were male. Six patients had BWS. Mean age at time of surgery was 16 months (age range 6 to 52 months). Patients spent a mean of one day in the PICU. Mean and median hospital length of stay was two days. Favorable results were obtained regarding tongue mobility, speech, aesthetics and orthodontia. There were no major complications. The oldest patient in the series was four years old at the time of surgery. This allowed for detailed pre and postoperative analysis. The patient achieved correction of anterior open bite, speech, tongue posture and oral competence.
Conclusion: Early results from our small cohort of patients who had partial glossectomy and enhanced recovery are positive and show a decreased hospital length of stay compared to the national average.
