Transoral Laser Excision of a Lingual Thyroglossal Duct Cyst
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Author: Soham Roy
Published:
Specialties: Otolaryngology, Pediatric Surgery
Schools:
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The lingual thyroglossal duct cyst (LTGDC) is a rare variant of the most common congenital neck mass, the thyroglossal duct cyst. The presentation of this atypical cyst is often due to symptoms of upper airway obstruction, and can lead to infant death if left untreated.
Procedure
Transoral Excision of Lingual Thyroglossal Duct Cyst with Epiglottopexy
Indications
Symptomatic airway obstruction with stridor, retractions, failure to thrive
Contraindications
Medical instability for Surgery
Instrumentation
Setup
Transoral tongue base approach either through laryngoscope, or via transoral base of tongue approach using telescopes and Weider ("sweetheart") retractor
Preoperative Workup
MRI or CT scan to confirm presence of suspected cyst
Anatomy and Landmarks
Transoral excision performed with dissection around cyst capsule, being careful to excise entire mass
Advantages/Disadvantages
Complications/Risks
Airway obstruction, bleeding
Disclosure of Conflicts
Airway obstruction, bleeding
Acknowledgements
The authors say a special thanks to David White, MD, FACS, FAAP for his expertise and suggestions prior to performing this surgery
References
1. Burkhart, C. M., Richter, G. T., Rutter, M. J., & Myer, C. M. (2009). Update on endoscopic management of lingual thyroglossal duct cysts. The Laryngoscope, 119(10), 2055-2060.
2. Urao, M., Teitelbaum, D.H., & Miyano, T. (1996). Lingual thyroglossal duct cyst: a unique surgical approach. Journal of pediatric surgery, 31(11), 1574-1576.
3. Rahbar, R., Yoon, M. J., Connolly, L. P., Robson, C. D., Vargas, S. O., McGill, T. J., & Healy, G. B. (2008). Lingual thyroid in children: A rare clinical entity. The Laryngoscope, 118(7), 1174-1179. doi:10.1097/MLG.0b013e31816f6922
4. Nguyen, A. M., Chelius, D. C., Baker, K. A., & Weatherly, R. A. (2013). Optimal Positioning Techniques With Fiberoptic Laser Excision in the Treatment of Congenital Tongue Base Lesions. The Laryngoscope, 123(6), 1552-1555.
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