True Congenital Macroglossia Surgically Managed Using a Modified Kole Technique

Abstract

Objective: To describe a 2-year old boy with true congenital macroglossia surgically managed using a modified Kole technique. 
 Methods:
 Study Design: Surgical Innovation
 Setting: Tertiary Government Hospital
 Patient: One
 Results: A 2-year-old boy presented with congenital macroglossia, associated with difficulty feeding and phonating. On physical examination, the massive tongue had both increased length and width. At rest, it protruded between the upper and lower teeth, with drying and fissuring of the tip. Dribbling of saliva and mandible prognathism were also noted. The child was surgically treated with a modified Kole technique, wherein the apex of the anterior wedge resection was extended to the posterior third midline. Final histopathology was consistent with cavernous hemangioma.
 Conclusion: The modified Kole technique proved viable, as the postoperative results were considered satisfactory. Tongue volume was uniformly reduced in length and width, enabling mouth and jaw closure, while tongue sensation and mobility were preserved. Feeding, speech intelligibility and cosmesis were markedly improved. Future application of this modification may prove its usefulness. 
 Keywords: macroglossia; glossectomy; congenital macroglossia