Clinical characteristics of 23 cases in two months old of neonatal lingual thyroglossal duct cysts

Abstract

Objective To analyse the clinical characteristics of infants in two months old of lingual thyroglossal duct cysts (LTGDC) and raise the levels of diagnosis and treatment. Methods A comparative analysis was made between the clinical data of 23 cases in two months old of LTGDC and those of 20 cases in one to seven years old of cervical thyroglossal duct cysts (TGDC) (control group). Results The clinical manifestation appeared obviously differences between LTGDC and TGDC. The main performance of LTGDC was laryngeal stridor, and 74% of them went to emergency department because of dyspnea. They would be misdiagnosed as congenital laryngomalacia or laryngomalacia with pneumonia. The lesion located in the posterosuperior of lingual bone and behind the root of tongue, which was easy to lead to throat obstruction because it extruded laryngeal cavity. Electronic laryngoscopy was the first choice, it helped to identify laryngomalacia, epiglottis cyst and hemangioma. Laryngeal CT or MRI was very important to diagnose LTGDC which was quasi-circular low density shadow with clear boundary, or not extruded to laryngeal cavity, or show lesion range and surrounding structures avoiding misdiagnosis. As treatment depended surgery which was self-retaining laryngoscope, it was minimally invasive and without scar. Cervical anterior mass in the midline was the first symptoms in all 20 cases of TGDC. The neck ultrasound examination was the first selection, and the lesion showed fluid dark space with clear boundary, it should take the neck percutaneous surgical operation. Conclusion The clinical manifestation of infants in two months old of LTGDC appears obviously different from TGDC. LTGDC is a common cause of laryngeal stridor with breathing difficulties. It will be misdiagnosed as congenital laryngomalacia and lead to asphyxia or death easily. Key words: Lingual thyroglossal duct cyst; Dyspnea; Infants