Transoral laser-assisted microscopic excision for lingual thyroglossal duct cyst.

PURPOSE: Thyroglossal duct cyst (TGDC) management, particularly lingual variants, poses challenges in treatment due to its anatomical location and potential for recurrence. This study aims to introduce a novel technique for managing lingual TGDC, combining transoral laser microscopic excision with cauterization of the hyoid mid portion, to improve treatment efficacy and reduce recurrence rates.

METHODS

The effectiveness of this approach was evaluated in 11 patients (age range: 2-16 years), including three cases with recurrent TGDC following simple transoral excision at other institutions. Procedures were performed under general anesthesia with meticulous attention to complete cyst removal and CO2 laser cauterization of the hyoid bone.

RESULTS

Patients experienced rapid postoperative recovery, and there were no instances of recurrence during a median 42-month follow-up period. The success of this technique suggests its potential as a standard approach for managing lingual TGDC.

CONCLUSION

The recurrence cases observed underscore the importance of adjunctive measures such as laser cauterization of the mid-portion of the hyoid bone in preventing recurrence. This highlights the significance of comprehensive management strategies in treating TGDC effectively.

LEVEL OF EVIDENCE: IV.