Macroglossia

Description:

The macroglossia is an increase in language. Normative indicators of the sizes of language of a fruit (length, width) in different durations of gestation are so far developed, however most of specialists prefer to do the conclusion about existence of a macroglossia on the basis of detection of language outside an oral cavity when studying a profile of a fruit. It is necessary to emphasize that the diagnosis of a macroglossia is competent only when language resides outside an oral cavity. Episodes of protrusion of language cannot be treated as a macroglossia.

Macroglossia reasons:

The expressed increase in the sizes of language quite often is noted at Bekvit's syndrome - Wiedemann, a hypothyroidism, a hepatoblastoma, Vilms's tumor, a glycogenosis, a mukopolisakharidoza and an alcoholic syndrome of a fruit, but the combination of a macroglossia and a Down syndrome is of special interest.

Macroglossia symptoms:

Post-natal researches show that the macroglossia and a smoothed profile are often observed at children with a Down syndrome. To the submitted SI. Kozlova and соавт., at children with a Down syndrome the abnormal profile is registered in 80% of cases. According to results of specially conducted prenatal researches in Great Britain it was established that in a series from 69 fruits with a trisomy 21 macroglossias at ultrasonography were revealed in 10% of observations to 28 weeks of pregnancy and in 20% of cases after 28 weeks. According to N. P. Veropotvelyan and соавт., the macroglossia was registered at 3 (13%) from 23 fruits with a Down syndrome in terms from 19 to 31 weeks of pregnancy. In all these cases at fruits with a Down syndrome the combined anomalies of development or ekhografichesky markers of chromosomal defects were noted.
T. A. Zakharchenko and I. A. Drachevskaya bring the description of prenatal diagnosis of a macroglossia, a polydactylia of the right brush and brakhimeliya at a fruit with a Down syndrome into 32 weeks of pregnancy. I. I. Ryabov also stated a macroglossia, a hypoplasia of bones of a nose, a dysplasia of auricles, a gipotelorizm, hyper echoic focus in a left ventricle and a right-hand hydronephrosis at a fruit with a Down syndrome in 31-32 weeks of pregnancy.

However not all researchers note presence of a macroglossia at fruits with a trisomy 21. So, E. V. Yudina (27 fruits with a Down syndrome) and T. V. Zolotukhina and соавт. (33 observations of a Down syndrome) in one case did not find a macroglossia. In 2000 N. Maclachlan and соавт. published results of poll of 179 obstetric departments of ultrasonic diagnosis of Great Britain devoted to use of ekhografichesky markers in prenatal diagnosis of a Down syndrome. In one clinic the macroglossia at a fruit was not registered as the indication to prenatal karyotyping.

One of the rare reasons for the expressed macroglossia the fruit can have a language tumor. In one of our observations at a fruit with a macroglossia after the birth of a byladiagnostirovan of a gemlimfangiom of language. In 34 weeks of pregnancy when studying structures of the person of a fruit continuous finding of language outside an oral cavity was noted. During prenatal karyotyping of chromosomal anomalies it was not revealed. At repeated ultrasonography in 37 weeks of pregnancy the macroglossia remained. After the delivery the child was transferred to specialized surgical department where at additional inspection the tumor regarded at a histologic research as a gemlimfangioma was revealed.

A year later the Italian researchers of D. Paladini and соавт. published the second observation of prenatal ultrasonic diagnosis of a lymphangioma of language. In the observation presented by them the diagnosis was established in 33 weeks of pregnancy. The lymphangioma was followed by a macroglossia and was presented by cystous structure the sizes of 35x30 mm. In 37 weeks increase in a cystous component up to 45x34 mm was noted. The diagnosis of a lymphangioma was confirmed at a histologic research after the delivery.

Treatment of a macroglossia:

Treatment of the main pathology is carried out.