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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Basic Info

Contributors: Blaine D. Smith and Jaecel Shah

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.

 

Advanced

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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