Macroglossia

The normal size of a tongue is variable and differs with increasing age with the greatest growth occurring in the first 8 years since birth and attaining full growth at 18 years of age. Macroglossia generally refers to long term painless enlargement of the tongue. The term macroglossia is defined as the resting tongue, which protrudes beyond the alveolar ridge or teeth. Macroglossia is an uncommon anatomical abnormality and is usually a sign of an underlying condition and rarely seen alone. It is seen in a wide variety of conditions. Isolated macroglossia is very rare and is inherited as an autosomal dominant trait. Depending on the size of the tongue and other structures in the oral cavity, it can be classified as true macroglossia and relative macroglossia.  True and relative macroglossia may be further subdivided into congenital and acquired disorders. In true macroglossia, there is an apparent enlargement of the tongue due to an underlying disease or condition, and relevant histopathological findings can be noted. In relative macroglossia, the tongue appears larger than compared to other structures in the oral cavity. Prominent examples include Down syndrome, where tongue appears enlarged due to hypotonia and Pierre Robin syndrome due to micrognathia.