Timing of reduction glossoplasty and clinical outcomes in children with Beckwith-Wiedemann syndrome.

BACKGROUND

Macroglossia in pediatric patients, particularly those with Beckwith-Wiedemann syndrome (BWS), can cause airway compromise, feeding difficulties, and dentofacial abnormalities. However, the optimal timing of reduction glossoplasty and its impact on clinical outcomes remain uncertain. This study aimed to evaluate the clinical outcomes of reduction glossoplasty in children with BWS, with particular emphasis on the association between age at surgery and postoperative outcomes.

METHODS

We retrospectively reviewed 21 pediatric patients with macroglossia who underwent reduction glossoplasty between 2017 and 2025 at a single institution. Patients were stratified into younger and older groups according to the median age at surgery (16.8 months). Associations between age at surgery and postoperative outcomes were analyzed.

RESULTS

All patients had BWS. Malocclusion occurred in 61.9% of patients and was significantly associated with older age at surgery (median 23.3 vs. 13.4 months, P = 0.004). The prevalence of malocclusion was significantly higher in the older group than in the younger group (90.9% vs. 30.0%, P = 0.012). Wound dehiscence occurred in 33.3% of patients but was managed conservatively in most cases, resulting in a reoperation rate of 14.3%. Age at surgery was not associated with postoperative complications (P = 0.799). Oral feeding was initiated at a median of 3.2 postoperative days and was delayed in patients who developed complications (P = 0.031).

CONCLUSIONS

Reduction glossoplasty is a feasible treatment for children with BWS-associated macroglossia. Younger age at surgery was associated with a lower prevalence of malocclusion, whereas age at surgery was not significantly associated with postoperative complications. These findings support individualized surgical decision-making that balances potential dentofacial benefits against perioperative risks.