Congenital macroglossia is associated with a variety of syndromes, mos
t commonly Down syndrome and Beckwith-Wiedemann syndrome. Clinically,
macroglossia may result in respiratory compromise, dysphagia, and poor
cosmesis. A variety of treatments have been proposed, with surgical r
esection being the most common. We review management and describe a ne
w surgical technique, consisting of a keyhole resection to decrease th
e width and length of the tongue. Between 1990 and 1992, five keyhole
resections for congenital macroglossia were performed on four consecut
ive children at Texas Children's Hospital, Baylor College of Medicine,
Houston. Patients had improved cosmesis and improved function of the
oropharyngeal airway, with no change in speech and feeding, Keyhole re
section is an effective treatment for macroglossia.