Keyhole tongue reduction

Macroglossia, although relatively uncommon, can lead to significant morbidity such as compensatory mandibular overgrowth, compromised oral competence, and chronic exposure and breakdown of tongue mucosa. Surgical debulking of the enlarged tongue is reserved for patients with significant morbidity. The methods of surgical correction of macroglossia are many, none of which are superior. Early techniques focused on reducing the tongue through nonspecific debulking, but more current techniques focus on preserving lingual mobility, maintaining adequate length and avoiding injury to the neurovascular bundles. The keyhole technique is a specific technique that incorporates both an anterior wedge resection and a central tongue reduction. This allows for protection of the lateral neurovascular bundles while performing significant debulking of the tongue. Postoperative results have demonstrated good mobility and positive effects on speech.