what is glossoptosis

Every individual has a unique pattern of growth and development. Some people may develop a perfect set of teeth, while others may experience developmental discrepancies. Some of the common developmental disabilities include autism, Down’s syndrome, cerebral palsy, and spinal cord injury. These disabilities often affect the development of the significant parts of our body like the brain, body, and mouth. Glossoptosis is one of the common craniofacial abnormality found in people with a developmental disability.

Glossoptosis is an oral condition which involves a downward and backward displacement of the tongue. Such positioning of the tongue blocks the throat and pharynx. The consequences of glossoptosis may include obstructed airway and an inability to suck and swallow. Usually, this abnormality is also associated with congenital syndromes like Pierre Robin sequence and Down’s syndrome.

Glossoptosis, in most cases, can be treated adequately. Infantile age is the most suitable time to get the tongue abnormality corrected. Early diagnosis and treatment allow the proper growth and development of the tongue. Additionally, it relieves the airway obstruction, which may potentially threaten the life of a child. Let’s continue to read the article to know more about the characteristics of glossoptosis and its associated treatment.

What do you mean by glossoptosis?

Glossoptosis is a tongue disorder which causes abnormal positioning of the tongue in the mouth. Often, in glossoptosis, the tongue is displaced downwards and retracted backward. Such positioning of the tongue makes swallowing difficult. Moreover, it obstructs the throat and pharynx that may complicate breathing. (1) Most commonly, glossoptosis occurs as a craniofacial abnormality in Pierre Robin syndrome and Down’s syndrome. Additionally, glossoptosis is also associated with obstructive sleep apnea.

What causes glossoptosis?

Pierre robin syndrome is one of the most common developmental disability associated with glossoptosis. The National Institue of Health added that Pierre robin syndrome exhibits three typical oral signs that include micrognathia (small jaw), cleft palate and glossoptosis.

Having a small-sized jaw often affects the proper positioning of the tongue. Additionally, it affects the adequate formation of the infant’s palate. A survey study showed that more than 12 per 100,000 live births suffer from Pierre Robin syndrome. (2)

Other developmental disorders associated with glossoptosis is down’s syndrome. Down’s syndrome is a genetic disorder which is caused by the presence of the third copy of chromosome 21.

What is the treatment for glossoptosis?

Prognosis of glossoptosis is likely to be effective by early diagnosis and treatment.

Diagnosis

Diagnosis of glossoptosis is often made at birth or within a few months after birth. This is because of its association with other developmental disorders. A prenatal ultrasound can detect the presence of developmental abnormalities in the fetus. However, a clear distinction between micrognathia, cleft palate, or glossoptosis may not be achievable by ultrasound alone. (3) A definitive diagnostic test, including DNA testing and previous family history, may confirm the syndrome.

Treatment

Glossoptosis mainly interferes with breathing and feeding of the infant. Inadequate respiration can lead to reduced birth weight and the inability of the infant to thrive for a long time. (4) Treatments like Prone positioning may help to allow relief from airway obstruction.

  • Prone positioning is a method where the baby is allowed to sleep on the stomach. Such positioning leads to the downward placement of the jaw. Additionally, it will enable the tongue to move forward, which reduces the airway obstruction.
  • A second non-surgical treatment for glossoptosis may include nasopharyngeal airway. This process involves the insertion of a tube into the nasal passage, which allows open airway and maintains supplemental oxygen supply.

Most of the times, a non-surgical approach can suffice the symptoms of glossoptosis. However, surgical intervention may be required in some cases to reposition the tongue.

  • Tongue-lip adhesion, also known as glossopexy is a surgical treatment which may be considered due to the failure of the non-surgical approach. This technique is done to place the tongue in a forward direction, clearing the airway passage.

The success rate of tongue-lip adhesion is high. Moreover, it allows non-interference with the growth and development of the lower jaw and teeth. This surgical technique is usually performed by an otolaryngologist or an oral surgeon sisted by a plastic surgeon. Tongue-lip adhesion is a reversible procedure. The tongue is usually brought back to the normal position once the infant’s mouth and jaw have achieved proper growth.

What is the prognosis for glossoptosis?

As alarming glossoptosis may sound to new parents, it is a manageable oral condition. There are several care options available that may help to ease the process of breathing for the baby. Moreover, post-surgical care allows the proper growth and development of the infant.

Usually, after treatment, an infant can resume unobstructed growth and developmental patterns by the age of four or five years. However, for the successful recovery and growth, you may have to monitor the baby’s feeding and breathing carefully.

Follow up for regular doctor’s appointments to keep a check on the health and well-being of your child. Additionally, you can take guidance from your doctor to plan the feeding habits of your child.

Take away message

Glossoptosis is a craniofacial abnormality which is often associated with developmental disabilities like Down’s syndrome and Pierre robin syndrome. The main clinical feature of glossoptosis includes downward and backward placement of the tongue. This positioning of the tongue blocks the throat and pharynx. Additionally, glossoptosis interferes with the feeding and breathing of an infant.

Although it may sound alarming, glossoptosis is a reasonably manageable disorder. Early diagnosis and prompt treatment can help to restore the health of the baby. Often prenatal ultrasound detects the presence of developmental abnormalities. However, a definitive diagnosis is made after birth. Treatment of glossoptosis includes non-surgical approach like prone positioning and nasopharyngeal airway.

The surgical procedure comprises of tongue-lip adhesion, which can be reversed once the baby resumes healthy growth and development. Post-treatment monitoring and care are equally essential for the success of the treatment. Usually, children start to have healthy growth and development by the age of 4-5 years. Consult your doctor for more advice on infantile care and keep a check on the health of your baby.