National trends in tongue reduction surgery for macroglossia in children

Abstract

ObjectivesTo examine the frequency of partial glossectomy performed for the indication of macroglossia in children within the United States, assessing for differences in rates of intervention across various demographics.To identify potential morbidities associated with partial glossectomy in this population and determine how such factors may influence length of stay and cost of admission following tongue reduction surgery. Study DesignRetrospective cross-sectional study. SettingThe Kids' Inpatient Database 2003, 2006, 2009, and 2012. SubjectsPatients under age 5 diagnosed with macroglossia who underwent partial glossectomy. MethodsDemographics were analyzed and cross tabulations, linear regression modeling, and multivariate analysis were performed. ResultsDuring the four-years studied, partial glossectomy was performed in 196 children under age 5 with macroglossia. A disproportionately higher rate of intervention was seen in white children (p = 0.001), patients undergoing surgery in the mid-west (p < 0.001) and patients in the highest socioeconomic quartile (p = 0.015). Most patients underwent glossectomy in their second year of life. The average length of stay in patients who underwent partial glossectomy for macroglossia was 9.59 days (Range 1–211 days, median 3.45 days) and the average cost was $56,602 (median $16,330). ConclusionPartial glossectomy for macroglossia is typically performed prior to age 2 in the United States. A higher rate of intervention is seen in white children, those who have surgery in the mid-west and affluent children even when controlling for confounding variables. Level of evidenceIII.