Lingual Thyroglossal Duct Cyst Research Articles

Avascular midline oropharyngeal anatomy allows for expanded indications for transoral robotic surgery in pediatric patients.

Transoral robotic surgery (TORS) in children is in its infancy, and indications have been primarily limited to lingual tonsillar hypertrophy and superficial mucosal lesions. However, the relatively avascular channel of the midline posterior tongue, vallecula, and posterior hyoid space provides a safe plane of dissection for deep lesions of the tongue and access to structures in the anterior neck. As robotic surgeons gain experience, application of this technology will continue to grow. The method is retrospective case series. We present seven patients who had either a primary (n = 3) or recurrent (n = 4) lingual thyroglossal duct cyst (TGDC) and underwent TORS excision. Four of the seven patients also underwent transoral resection of the central portion of the hyoid bone, while three had central hyoid resection during prior surgery. Two minor complications occurred with no evidence of lesion recurrence after mean follow-up of 19.7 mo. The midline avascular channel of the tongue allows for relatively bloodless surgical access to pathologies of the midline base of tongue and anterior neck. Lingual thyroglossal duct cysts can safely be removed via aTORS approach with evidence of limited recurrence. Robotic technology can provide safe and effective surgical alternatives for children with a variety of pathologies, and we aim to promote the widespread adoption of TORS in pediatric head and neck surgery by sharing our knowledge and clinical experience. Further study and publication are needed to establish safety and efficacy.

Transoral Robotic Excision of Paediatric Lingual Thyroglossal Duct Cyst.

Lingual thyroglossal duct cyst (TGDC) is a rare variant of TGDC that emerges within the tongue base. It presents a unique surgical challenge. There are different approaches to managing this condition. Transoral robotic surgery (TORS) has been successfully used for lesions of the tongue base in adults. This report presents a 7year old boy with a cystic lesion in the base of tongue, which was diagnosed to be a lingual TGDC. The cyst was excised transorally using Da Vinci Robotic system. The surgery was performed in a short operating time with no complications or recurrence on follow up. TORS is an effective and reliable method of excision of lingual TGDC in the paediatric population. Lingual TGDC can be managed by simple excision of the cyst without excision of hyoid bone. Further studies are needed to confirm the safety and recurrence rates of this technique in paediatric population.

Transoral robotic surgery for treatment of lingual thyroglossal duct cyst

Objective: To investigate the feasibility, safety and efficacy of transoral robotic surgery (TORS) in the treatment of lingual thyroglossal duct cyst (LTGDC). Methods: The clinical data of 10 patients with LTGDC treated with TORS in Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from May 2017 to November 2020 were analyzed retrospectively,including 6 males and 4 females, aged 5-44 years. The cysts were fully exposed, and resection usually started from the cephalic side of lesions. The range of resection was 3 to 5 mm away from the lesions, and partial hyoid bone was removed if necessary. Intra-operative robotic set-up time,operation time and estimated blood loss,and post-operative local bleeding, dyspnea and recovery time for oral intake were analyzed. SPSS 12.0 software was used for statistical analysis. Results: The cysts in all 10 patients were successfully resected by TORS with da Vinci Si surgical system. The mean robotic set-up and exposure time, operation time, estimated intraoperative blood loss and recovery time for oral intake were (15.5±7.1) min, (17.6±7.4) min, (8.9±6.4)ml and (2.3±2.2)days, respectively. No patient required tracheostomy intra-or post-operatively, and no symptoms of airway obstruction, postoperative bleeding, pharyngeal fistula, hoarseness and neurological impairment occurred after operation. The patients were followed up for 5 to 47 months, with median follow-up time of 17 months, and no recurrence was observed. Conclusion: TORS is safe and feasible for resection of LTGDC, with rapid recovery and low recurrence rate.

Symptomatic Lingual Thyroglossal Duct Cyst in Children: A Laryngomalacia Phenotype.

Patients with lingual thyroglossal duct cyst (TGDC) can present as symptomatic with obstructive airway and feeding difficulties. We present 3 cases of symptomatic lingual TGDC. All 3 patients were diagnosed with laryngomalacia and underwent further concurrent or delayed airway intervention, in addition to cyst removal. We reason that there is a phenotype of laryngomalacia in the symptomatic lingual thyroglossal duct cyst patients who present with symptoms due to disruption in laryngeal anatomy rather than the cyst itself causing obstructive symptoms. Distinguishing this phenotype, especially in comparison to other pathologies such as vallecular cysts, may better allow for planning of concurrent or delayed airway procedures and overall counseling of parents.

Radiofrequency coblation assisted transoral excision of lingual thyroglossal duct cyst

Radiofrequency coblation (RFC) is a relatively new device that has been used in several transoral procedures. Currently, clinical data on its use for excising lingual thyroglossal duct cyst (LTGDC) are lacking. Herein, we conducted this retrospective case series to explore the feasibility and efficacy of RFC-assisted transoral surgery (RFC-TOS) in excising LTGDC. A total of 12 LTGDC patients between 2013 and 2020 were retrospectively studied. The cysts of these patients were all fully removed along the boundary to the depth of the hyoid using RFC wands. All surgeries were completed within 30 minutes. Only one patient had an intraoperative blood loss of more than 10 ml. All patients started oral feeding on the day of operation. The mean postoperative hospital stay was only 3.3 days (range 1-8 days). No surgical-related short-term and long-term complications were observed. One patient was lost to follow up, and no recurrences occurred during a mean follow-up period of 52.7 months among the other 11 patients. Therefore, we believe that RFC is a reliable tool in transoral operation for treating LTGDC. LTGDC patients who underwent RFC-TOS showed quick recovery, low risks of complications, and excellent clinical and functional outcomes.

A new transoral modality for the treatment of lingual thyroglossal duct cyst with suspension laryngoscopy by plasma coblation.

Lingual thyroglossal duct cysts (LTGDC) are a rare kind of thyroglossal duct cyst. However, Sistrunk surgery is not very suitable for this type of cyst. This study aimed to explore the efficacy of transoral excision of LTGDC by plasma coblation. The present study reviewed 11 patients, comprising seven males and four females, who had been diagnosed with LTGDC preoperatively by computed tomography (CT) and fibre-optic electronic laryngoscopy. Of those patients, two had recurrence after surgery of epiglottic cysts. All these patients underwent transoral excision by plasma coblation. Then, we collected preoperative data of the patients, observed the effect of surgery, and analysed factors relevant to LTGDC, including the estimated bleeding amount, postoperative hospitalisation, complications and recurrence rates. The connection between LTGDC and hyoid was tapered on sagittal images of CT, which was vital evidence for the diagnosis of LTGDC. Surgery was performed successfully for all 11 patients, and all recovered without complication. There was no evidence of recurrence after surgery, during follow up for 3-43months. Transoral surgery for LTGDC can be performed successfully by plasma coblation, which is an effective and safe surgical treatment. Fibre-optic electronic laryngoscopy and CT are essential to the diagnosis of LTGDC in order to avoid missing detection and misdiagnosis.

Experience of diagnosis and treatment of lingual thyroglossal duct cyst

Objective: To explore and analyse the imaging examinations, clinical presentation, operative methods complication and the surgical outcomes of lingual thyroglossal duct cyst (LTGDC) . Methods: The clinical data of 30 patients with LTGDC were analyzed retrospectively from January 2015 to October 2018 at the First Affiliated Hospital of Zhengzhou University. Results: 30 cases were treated with endoscopic coblation cauterization firstly. Follow-up for 7.5-45.0(25.4) months showed that 25 cases had no recurrence, 2 cases had no connection, 2 cases had recurrence once, and 1 cases had recurrence twice,the recurrence rate was 10.7%(3/28).Two patients recurred once, and the last operation was performed with endoscopic coblation cauterization, and no recurrence was found in the follow-up of 1 year; one patient recurred twice underwent the last operation with Sistrunk operation, and no recurrence was found in the follow-up of 1 year. There was no pharyngeal fistula and hoarseness in 28 patients. Conclusions: For LTGDC,especially, those of the first-episode children, endoscopic coblation cauterization is the first choice. Recurrent LTGDC can be treated by endoscopic coblation cauterization, so that patients with multiple recurrences can be considered the Sistrunk operation.

Presentation, Management, and Outcome of Lingual Thyroglossal Duct Cyst in Pediatric and Adult Populations.

Lingual thyroglossal duct cysts (LTDCs) are rare congenital anomalies of the neck. The authors described the presentation, management, and outcome of LTDC in pediatric and adult cases through a retrospective observational analysis between 2008 and 2018. Data included patients' demographics, main complaint, preoperative investigations, surgical management, and recurrences. Seventeen patients were included: 8 pediatric and 9 adult patients. The most common presenting symptom was foreign body sensation (35.3%). In all, 50% (4/8) of the children had respiratory problems, while the most common symptom in adults was difficulty swallowing (8/9). Five patients were of recurrent LTDC; 3 referred patients were suspected of having recurrent epiglottic cysts. The total misdiagnosis rate was 35.3% (6/17): 14.3% (1/7) in children and 55.6% (5/9) in adults. Fiber optic laryngoscopic examination revealed that LTDCs mostly occurred at the base of the tongue (53.3%) and vallecula epiglottica (33.3%). Ultrasound examination revealed low to anechoic masses on the root of the tongue; 50% were regular in shape and 50% were irregular. All pediatric patients had regular masses (100%), but most adults had irregular masses (85.7%). In total, 76.5% of the patients underwent the Sistrunk procedure, and 23.5% underwent marsupialization alone. The mean follow-up length was 37.5 ± 32.8 months. All patients were well at follow-up. In conclusion, direct laryngoscopy and ultrasound examination are essential for diagnosis as LTDCs can be confused with vallecular cysts. Surgical treatment such as marsupialization or the Sistrunk operation must be performed thoroughly.

1024 Large Posterior Lingual Thyroglossal Duct Cyst Pneumatically Splinted with Auto-Continuous Positive Airway Pressure at Low Pressures

1024 Large Posterior Lingual Thyroglossal Duct Cyst Pneumatically Splinted with Auto-Continuous Positive Airway Pressure at Low Pressures

Large posterior lingual thyroglossal duct cyst pneumatically splinted with auto-continuous positive airway pressure at low pressures

Large posterior lingual thyroglossal duct cyst pneumatically splinted with auto-continuous positive airway pressure at low pressures

A rare case of a lingual mass in a neonate

A large lingual cyst was noted on the 22-week antenatal ultrasound, which grew in proportion to the foetus on serial imaging. An elective c-section was performed in view of possible airway obstruction, and the neonate initially required oxygen to maintain saturations. Aged 1 month, the baby developed significant breastfeeding difficulties secondary to rapid cyst and secondary tongue enlargement, completely filling the oral cavity. Fifteen millilitres of fluid were aspirated in clinic, resulting in reduction of tongue size and immediate improvement in feeding. The patient subsequently underwent surgical excision of the cyst, which filled most of the anterior two-thirds of the tongue up to the foramen caecum. Histology supported the diagnosis of lingual thyroglossal duct cyst. A rare variant of thyroglossal duct cysts, these cysts can be potentially difficult to manage. More commonly located in the tongue base, we present an even rarer variant, that of an anterior tongue cyst.

Transoral robotic excision of a lingual thyroglossal duct cyst

Lingual thyroglossal duct cysts are a rare and potentially difficult to manage tongue base lesion. We report a case of transoral robotic surgical excision of a lingual thyroglossal duct cyst, in an adult patient. A 68-year-old man presented with a large base of tongue mass, with appearance on ultrasound and computed tomography consistent with a lingual thyroglossal duct cyst. We describe the surgical technique for transoral robotic excision of the cyst. The cyst was completely excised, and the patient had a smooth recovery. There has been no recurrence of the cyst. Transoral robotic surgery has several advantages over the conventional surgical approaches in the treatment of lingual thyroglossal duct cysts, including superior visualisation, and the ability of the robotic surgical system to manoeuvre instruments in a confined space. This enables complete excision, preventing recurrence of the cyst whilst also avoiding a neck scar.

Prenatal Ultrasound Diagnosis of a Cyst of the Oral Cavity: An Unusual Case of Thyroglossal Duct Cyst Located on the Tongue Base.

We describe a case of a lingual thyroglossal duct cyst diagnosed prenatally by ultrasound at 26 weeks of gestation. The follow-up ultrasound scans revealed no changes in the cyst measurement. Surgical treatment was performed without any complication 72 hours after delivery with good results.

5p 欠損症候群の喉頭軟化症に舌根部甲状舌管囊胞を合併した1 例

5p 欠損症候群の喉頭軟化症に舌根部甲状舌管囊胞を合併した1 例

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

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

Acute Upper-Airway Obstruction by a Lingual Thyroglossal Duct Cyst and Implications for Advanced Airway Management

Respiratory failure in infants and children is a common cause of ICU admission, and diseases that jeopardize the airway are the most frequent cause of cardiac arrest in neonatal and pediatric patients.[1][1],[2][2] In neonates specifically, there are numerous causes for respiratory distress, with

A rare report of foetal lingual cyst excised with harmonic scalpel

Diagnosis of foetal lingual cysts is extremely rare. If large enough, it can compromise the upper oropharyngeal airway. A case of a large ventral lingual thyroglossal duct cyst mimicking a ranula was identified at 20 weeks of gestation and excised 11 weeks postnatally using the harmonic scalpel. The diagnosis and the benefit of ultrasonic dissection in the treatment of glossal lesions are reviewed.

Stridor and lingual thyroglossal duct cyst in a newborn

To describe the diagnosis and management of lingual thyroglossal duct cyst in newborns. A one-month-old girl presenting with inspiratory stridor and chest wall retraction was referred to our department for management of stridor. Upper airway endoscopy and neck CT scan showed a round mass at the base of the tongue causing upper airway obstruction. Computed tomography showed a well-circumscribed, low-density lesion at the base of the tongue. Endoscopic marsupialization of this lesion was performed under general anaesthesia. Histological examination confirmed the diagnosis of lingual thyroglossal duct cyst. No recurrence was observed 18 months after endoscopic treatment. Lingual thyroglossal duct cyst with airway obstruction is an uncommon aetiology of stridor in newborns with symptoms similar to those of laryngomalacia. The diagnosis is based on laryngoscopy. Surgical endoscopic removal is the treatment of choice. Recurrence after endoscopic treatment is rare.

Lingual thyroglossal duct cyst with recurrence after cystectomy or marsupialization under endoscopy: Diagnosis and modified sistrunk surgery

To explore the radiologic characteristics of lingual thyroglossal duct cyst relevant to diagnosis. In addition, to probe the feasibility of modified Sistrunk surgery for patients who experience recurrence after cystectomy or marsupialization under endoscopy. Retrospective. Seven patients, three male and four female, who had been diagnosed with lingual thyroglossal duct cysts, had received cystectomy or marsupialization under endoscopy between one and eight times with cyst recurrence soon after every operation. All of these cases were evaluated by CT before proceeding with the latest modified Sistrunk surgery. During surgery, we routinely used methylene blue to trace the cysts, and then we used an enlarged Sistrunk procedure for such cases. The CT images demonstrated that there were cysts located posteriorly to the tongue that had a close relationship with the hyoid bone and the foramen cecum. In addition, the results of the pathological examinations were consistent with thyroglossal duct cysts. During the postoperative follow up of 18 to 31 months, the patients did not show any symptoms or signs of recurrence. The results of their most recent examinations, two by laryngoscopy and five by CT scan, did not reveal any abnormality in their pars laryngea pharyngis. CT could differentiate lingual thyroglossal duct cysts from the other cysts occurring at the lingual root. For those patients with lingual thyroglossal duct cysts that recur after cystectomy or marsupialization under endoscopy, the modified Sistrunk operation could be a suitable treatment option.

Diagnosis and treatment of lingual thyroglossal duct cyst in newborns

The objective of this study was to explore the diagnosis and treatment method of lingual thyroglossal duct cyst in newborns. The clinical data of nine newborns who were diagnosed as lingual thyroglossal duct cyst were retrospectively analyzed. One lingual thyroglossal duct cyst was found when the tongue was pressed with a spatula. The other eight lingual thyroglossal duct cysts were found with a laryngoscope. Three-dimensional computed tomography showed that the cysts were located at the base of tongue, which was round and smooth. Six of nine patients were treated with the puncture method. The fluid was drawn out, and the average volume was 1.4 mL. Follow-up survey lasted for 1 year or more and 33.3% (2/6) of the cases recurred. For the recurrence, the two patients underwent another operation in which most of the cyst walls were removed and they had no recurrence after another year of follow-up survey. Three of the nine patients were treated with the excision method, and they had no recurrence after 1 year of follow-up survey. The laryngoscope and three-dimensional computed tomography examinations are important for the diagnosis of lingual thyroglossal duct cyst. Surgical removal serves as a radical cure for lingual thyroglossal duct cyst.