Macroglossia as a presentation of the Beckwith-Wiedemann syndrome

Plastic surgeons are not infrequently required to reduce the size of a large tongue in a child. Macroglossia is one of the main presenting features of the Beckwith-Wiedemann syndrome. This comprises a spectrum of disorders that includes a high incidence of malignancy. Patients with this syndrome should be identified and carefully assessed to exclude serious complications. This paper reports a series of 30 patients presenting to the Royal Children's Hospital over an 8-year period. An incidence of malignancy of 10 percent is recorded.     

Macroglossia: a review of the condition and a new classification

In studying macroglossia, no one has described normal tongue size or applied direct measurement to the pathologically enlarged tongue. Since macroglossia is primarily a condition that requires treatment on a symptomatic basis, definition of the problem in clinical terms is the most useful form for the practitioner. Based on published reports and our clinical experience, a classification scheme for macroglossia has been formulated. The concept of true macroglossia and relative macroglossia form a framework that categorizes acquired and congenital forms of tongue enlargement. True macroglossia exists when histologic abnormalities correlate with the clinical findings of tongue enlargement. Vascular malformations, muscular enlargement, and tumors are the most common forms of true macroglossia. Relative macroglossia includes those cases of apparent tongue enlargement in which the histology does not provide a pathologic explanation. Down's syndrome is a commonly quoted cause for tongue enlargement and is a form of relative macroglossia. The development of this classification system establishes an approach and common terminology on which therapy, research, and communication can be based.     

Brachyptera Group. Sp.32. C. Brachyptera. Sp.33. C.c RUFA. Sp.34. C. Troglodytes. Sp.35. C. Fulvicapilla.

A part from considerations as to where it is best wedged into the linear sequence, the brachyptera group is defined in general terms as a compact group of four small or very small species which resemble one another in many important specific characters and the other thirty-six species classified here as Cisticola in so many ways of form, coloration and behaviour as to make them best understood by classifying them also under that generic name.     

Robusta-Natalensis Pair. Sp. 30. C. Robusta. Sp.31. C. Natalensis.

T he two giants of the genus-that is so far as the cock birds are concerned, but, as with chiniana and a few others, their hens are so much smaller that even when in the field the two sexes are seen in company one may often doubt their being a pair of the same species.