Midline Glossectomy and Lingualplasty

Midline glossectomy (MLG) has been used for many years to treat macroglossia. However, this procedure is quite invasive and results in considerable edema of the tongue. MLG is associated with significant postoperative pain. In addition, many patients require a tracheotomy to protect their airway. As a result, patients are reluctant to undergo this surgery.

A variation of traditional glossectomy surgery is the laser glossectomy and lingualplasty described by Woodson and Fujita (119). They reported a 77% responder rate using the criteria of a postoperative RDI less than 20. Despite these encouraging results, a complication rate of 27% was noted. Other transcervical submucosal approaches have been developed to resect a portion of the tongue base (120). However, these procedures can be complicated and require extensive dissection. Typically, these surgeries require placement of a tracheotomy tube and thus meet patient resistance.

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