Perioperative Anesthetic Management of Reductive Glossectomy in an Adult Patient Suffer from Hypertention with Macroglossia: A Case Report

Abstract

Introduction: Macroglossia is a rare anatomical abnormality characterized by the enlargement of the tongue beyond the teeth or alveolar ridge. This condition can lead to various complications, including malocclusion, airway obstruction, obstructive sleep apnea (OSA), dyspnea, and impairments in speech and swallowing. Treatment primarily focuses on addressing the underlying etiology, but when medical management fails, surgical intervention provides symptomatic relief. Case Presentation: A 57-year-old man was scheduled for reductive glossectomy due to macroglossia. The patient experienced dyspnea and OSA as a result of an abnormally enlarged tongue. Reductive glossectomy was performed successfully without complications. Postoperatively, the patient remained intubated and was monitored overnight. He was discharged in stable condition 24 hours later. Conclusions: Partial glossectomy is a safe and effective treatment for macroglossia, offering significant symptomatic relief. Perioperative anesthetic management requires careful clinical judgment. Given the patient’s severe macroglossia, the nature of the surgery (debunking) involving the tongue and airway, and his history of nocturnal OSA, it was necessary to secure an intensive care unit (ICU) bed for postoperative monitoring. The patient remained sedated and intubated in the ICU to manage potential airway edema and oxygen requirements before extubation and discharge.