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Oral Surgery/tongue, no room in my maxillary arch


I am crying out for help and I am really running out of where to go. For as long as I remember I have had problems with my articulation, everybody else said I am fine but I knew it is not right. My tongue is not the right shape for my mouth it never has been. People do not understand but it feels I am trapped in a body because of my this. My tongue is to wide, I have a high palatal arch and a narrow maxillary arch this is restricting the mobility of my tongue and is effecting my articulation.

There is nothing on the internet I can find but I know my own body and I know it is not right.

This is all I can find, this really gets me down so much. I know where the tongue needs to go for the muscles but it can not get near the upper palate the sides go up because the tongue will not fit in the maxillary arch.

I am 31 now and live in England, I have tried everything, palatal appliances to widen my upper jaw in my mid twenties this tipped my upper teeth out and messed up my bite I had orthognathic surgery to correct my bite hoping this would fix this but it hasn't I had maxillary hypoplasia growing up and my upper maxilla was underdeveloped, the maxillofacial surgeon said everything is ok now and would not listen to my concerns. This is a disorder which I cannot find anything on I don't know anybody who specialises in measuring the maxillary arch the palate and the tongue during speech. I saw a speech therapist about 10 years ago and she said nothing was wrong.

I hope you can help me I am running out of options, I don't know any fields or terms or the disorder the closest I have found today is linguistic disorder.

Thank you for your time in reading this email.



Hello John,

Your case seems to be too complex to answer in one sentence. You really need to be assessed seriously by an expert Oral & Maxillofacial Surgeon and to judge if all treatments were done according to the latest techniques.
In very rare instances, partial resection of the tongue can be performed to help it fit inside your mouth with no pressure but most of the cases, jaw bones can be adapted to widen enough your  maxilla and mandible and gives you the comfort you need. There are no standard measurements for the tongue since the muscles than compose it are adaptative to the surrounding structures.
I would suggest going back to square one using all novel techniques and 3 dimensional imaging to try to solve your case.



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Chawket MANNAI, DDS,Ph.D Diplomate ABOMS


I am a US board certified Oral & Maxillofacial Surgeon trained at UCLA and Parkland Memorial Hospital (Dallas) with more than 25 years of experience and will provide answers to all questions pertaining to the Oral& Maxillofacial Surgery region including Orthognathic Surgery, Trauma,TMJ, Implantology, tumour surgery (excluding cancer and Oral Dermatology),reconstructive surgery...


Extensive in all fields for the past 25 years hospital and office based.

American Association of Oral & Maxillofacial Surgeons American College of Oral & Maxillofacial Surgeons British Association of Oral & Maxillofacial Surgeons

2006: Mannai Chawket Early implant loading in severely resorbed maxilla using xenograft, autograft, and platelet-rich plasma in 97 patients. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 2006;64(9):1420-6. Bayonne, France. 1998: Bell W H; Mannai C [An interview with Dr. W.H. Bell and Dr. C. Mannai. Interview by Colette Orival-Demange.] L' Orthodontie franšaise 1998;69(1):225-9. 1988: Abemayor E; Zemplenyi J; Mannai C; Webb D J; Canalis R F The fixation of malar fractures with the transnasal Kirschner wire. The Journal of otolaryngology 1988;17(4):179-82. Division of Head and Neck Surgery, Harbor-UCLA Medical Center, Torrance 90509. 1988: Wald R M; Abemayor E; Zemplenyi J; Mannai C; Lesavoy M A The transoral treatment of mandibular fractures using noncompression miniplates: a prospective study. Annals of plastic surgery 1988;20(5):409-13. Division of Plastic Surgery, Harbor/UCLA Medical Center. 1988: Di S; Bell W H; Mannai C; Seale N S; Hurt W C; Taylor J; Waite D E Long-term evaluation of human teeth after Le Fort I osteotomy: a histologic and developmental study. Oral surgery, oral medicine, and oral pathology 1988;65(4):379-86. Division of Oral and Maxillofacial Surgery, University of Texas Health Science Center, Dallas. 1988: Bell W H; Mannai C; Luhr H G Art and science of the Le Fort I down fracture. The International journal of adult orthodontics and orthognathic surgery 1988;3(1):23-52. 1986: Mannai C; Schwartz H C Juvenile nasopharyngeal angiofibroma presenting as a facial swelling. A case report. Journal of maxillofacial surgery 1986;14(6):329-31. 1986: Mannai C; Leake D; Pizzoferrato A; Ciapetti G; Sangiorgi C Histologic evaluation of purified bovine tendon collagen sponge in tooth extraction sites in dogs. Oral surgery, oral medicine, and oral pathology 1986;61(4):315-23.

DDS,Ph.D Fellow and Diplomate American Board of Oral & Maxillofacial Surgery Residency training:Harbor-UCLA MedicalCenter 1982-1985 Fellow OMFS Parkland Memorial Hospital Dallas Texas with William H.BELL

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