Comparative Morphometry of the Tongue of Children Without Signs of Anatomical and Functional Disorders of the Tongue and With Beckwith-Wiedemann Syndrome

Abstract

Introduction. No diagnostic assessment of the tongue can replace a well-founded clinical examination. An abnormally enlarged tongue, especially in syndromic pathology, is usually diagnosed clinically and confirmed using auxiliary imaging methods. However, when assessing the shape, size, and spatial relationships of individual anatomical regions of the tongue, ambiguity in diagnostic indicators remains a common challenge.

Aim. To conduct a comparative analysis of morphometric indicators of the tongue in children without signs of anatomical and functional disorders and with Beckwith–Wiedemann syndrome.

Materials and methods. The analysis included anonymized MRI data of children aged 6 to 12 years without anatomical and functional disorders (n = 29) and children aged 2 to 5 years with Beckwith–Wiedemann syndrome (n = 3). To establish a framework for accurate morphometric analysis, the tongue was segmented on midsagittal slices, and the total tongue area (S) was calculated as the sum of the areas of its anterior (S_a), middle (S_m), and posterior (S_p) segments.

Results. In Group 1 (Beckwith–Wiedemann syndrome, n = 3; mean age 3.7 ± 1.5 years), the largest mean values of segment areas were observed: S_a = 578 ± 33 mm², S_m = 749 ± 276 mm², and total tongue area S = 2063 ± 253 mm². In Group 2 (children aged 6–9 years without pathology, n = 13; mean age 7.5 ± 1.2 years), the mean values were S_a= 201 ± 54 mm², S_m = 405 ± 87 mm², and S = 714 ± 116 mm². In Group 3 (children aged 10–12 years without pathology, n = 16; mean age 11.1 ± 0.8 years), the corresponding values were, S_a = 239 ± 66 mm2, S_m = 477 ± 110 mm² and S = 881 ± 167 mm². In all three patients with Beckwith–Wiedemann syndrome, actual values of the total tongue area exceeded the predicted age-conditioned values calculated via a linear regression model based on the reference group (n = 29). The absolute excess ranged from + 726 to +1271 mm², and relative excess ranged from + 69% to + 142%. On average, for patients with Beckwith–Wiedemann syndrome, the measured total tongue area was 2063  ±  253 mm², whereas the predicted conditional age norm was significantly lower (1024 ± 117 mm²), yielding a mean absolute deviation of + 1040  ± 282 mm² and a mean relative deviation of + 104  ±  37%.

Conclusion. The comparative analysis of tongue morphometric indicators based on MRI data provides an objective quantitative assessment of the degree of tongue enlargement in pediatric patients with Beckwith–Wiedemann syndrome relative to predicted conditional age norms of the total tongue area on midsagittal slices.