Glossoptosis

What is glossoptosis?

Glossoptosis refers to an incorrect placement or displacement of the tongue. At birth, your infant’s tongue is farther back in their mouth than it should be. This positioning can block your child’s airway, affecting their ability to breathe, eat and swallow.

Glossoptosis is can be a symptom of a birth defect called Robin Pierre syndrome. An infant with this condition has a smaller-than-usual lower jaw (mandible). The small jaw causes their tongue to sit too far back in your child’s mouth. Glossoptosis can also occur with Down syndrome and cerebral palsy.

What causes glossoptosis?

Glossoptosis is a symptom that occurs with certain conditions like:

• Birth defects: A birth defect is a congenital condition, which means it’s present at birth. Something happens during pregnancy that affects how your baby’s body forms in the womb. There isn’t a way to prevent most birth defects.
• Genetic disorders: A genetic disorder occurs when there’s a change, or mutation, to a gene. Some adults have gene mutations that they pass to their children. Some gene changes occur spontaneously for no known reason. Often, there isn’t any way to prevent many genetic disorders.
• Neuromuscular disorders: These disorders affect the nervous system and musculoskeletal system. The tongue is a muscular organ. Children with certain neuromuscular disorders may have weak tongue muscles that cause their tongue to rest too far back in their mouth.

Who is at risk for glossoptosis?

Children with these conditions can have glossoptosis:

• Pierre Robin syndrome: Also known as Pierre Robin sequence, Pierre Robin syndrome is a birth defect that affects how your baby’s jaw forms while in the womb. Their lower jaw doesn’t fully develop and is smaller than usual. While in the womb, their small jaw may force your baby’s tongue to the roof of their mouth (palate). This can cause an opening called a cleft palate. Glossoptosis is apparent at birth. Your baby’s tongue sits far back in their mouth, closer to their throat.
• Cerebral palsy: Cerebral palsy is a neuromuscular disorder that occurs when there’s abnormal brain development in the womb or a brain injury during or after childbirth. The condition affects your child’s movement, balance and posture. Children with cerebral palsy have low muscle tone (hypotonia) or weak muscles, including their tongue muscle. As a result, their tongue may sit too far back in their mouth.
• Down syndrome: Down syndrome is a genetic disorder that occurs when an infant has one extra copy of chromosome 21. Chromosomes contain genes that make up your DNA. A child with Down syndrome may have hypotonia, flattened facial features and glossoptosis. They often have developmental delays and mild to moderate cognitive impairment.

What are the complications of glossoptosis?

The improper positioning of their tongue back toward their throat can affect your infant’s ability to take in enough oxygen through their trachea (windpipe). They may have difficulty breathing and shortness of breath. Glossoptosis can cause obstructive sleep apnea in children. Children with this condition temporarily pause their breathing during sleep. They may also snore.

Tongue displacement can also cause feeding problems like difficulty swallowing. Your infant may not be able to breastfeed or bottle-feed well enough to get the nutrients they need to grow. This can lead to what’s known as failure to thrive. Some children with glossoptosis also have speech and language issues.

How do providers treat glossoptosis?

Many children don’t need treatment for glossoptosis. Their jaw eventually grows along with the rest of their body. As they grow, their tongue has more room in their mouth, and glossoptosis goes away. Infants with Pierre Robin syndrome often have a normal-sized jaw by 18 months of age.

But some infants need help breathing while their jaw is small. They may need a breathing tube in their nose or throat to ensure they get enough oxygen. Rarely, a child needs a tracheostomy. This breathing tube connects to their trachea (windpipe) through a surgical incision in their neck.

An infant who can’t get enough nutrients to grow may need tube feeding (enteral nutrition).

In rare occasions, your baby may need surgery to reduce the size of their tongue. An infant with cleft palate often needs surgery to close the opening.

What can you do at home if your baby has glossoptosis?

Healthcare providers typically recommend placing your infant on their back to sleep. This supine position lowers the risk of sudden infant death syndrome (SIDS). But with glossoptosis, this position causes their tongue to fall even farther back toward their throat. It can cut off your child’s airway, contributing to obstructive sleep apnea. In rare instances, it may be fatal.

Your healthcare provider may recommend placing your baby on their stomach to sleep (prone position). Your provider can offer tips for making stomach sleeping safer for your baby.

What is the outlook for someone with glossoptosis?

Most children with small jaws that cause tongue displacement eventually have large enough jaws that glossoptosis is no longer a problem. A child who experiences swallowing or speech difficulties from glossoptosis may benefit from therapy.

When should I call the doctor?

Call your child’s healthcare provider if your child has difficulty:

• Breathing.
• Feeding.
• Speaking.
• Swallowing.

A note from Cleveland Clinic

Glossoptosis refers to an incorrect placement or displacement of the tongue. At birth, your infant’s tongue is farther back in their mouth than it should be. It’s understandable to have concerns if your baby’s tongue, jaw or facial features are different from what you expected. Tongue displacement toward the back of your baby’s mouth can affect their ability to breathe, eat and swallow. Fortunately, this symptom often improves as your baby’s jaw grows bigger. Your child’s healthcare provider will check for signs that may indicate your child needs help breathing or eating. Some children with glossoptosis benefit from speech therapy.