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. 2021 Jun;103(6):438-443.
doi: 10.1308/rcsann.2020.7073. Epub 2021 Apr 14.

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

K Gao  1 , J Han  1 , X Zhou  1 , D Luan  1 , F Xie  1 , Y Li  2 , Z Yue  1
Affiliations

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

K Gao et al. Ann R Coll Surg Engl. 2021 Jun.

Abstract

Introduction: 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.

Methods: 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.

Results: 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 3-43 months.

Conclusions: 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.

Keywords: Lingual thyroglossal duct cyst; Plasma coblation; Suspension laryngoscopy; Transoral surgery.

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Figures

Figure 1
Figure 1
Fibre-optic electronic laryngoscopy images showing preoperative cyst located to the midline in the posterior of the tongue (a) and the posterior of the tongue post-operation (b).
Figure 2
Figure 2
(a) Axial CT image of neck showing LTGDC. (b) Sagittal CT image of neck showing LTGDC. The arrow indicates the tapered connection between the LTGDC and the hyoid. CT = computed tomography; LTGDC = lingual thyroglossal duct cyst.
Figure 3
Figure 3
(a) Image of the preoperative cyst. The arrow indicates the previous surgical scar in a patient with recurrence. (b) Image of the operative region postoperatively.
Figure 4
Figure 4
Histological sections of the lesion showing that the squamous and pseudostratified ciliated column is epithelium of thyroglossal duct origin
See this image and copyright information in PMC

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