Coblation-Assisted Transoral Endoscopic Excision of Lingual Thyroglossal Duct Cysts.

ImportanceLingual thyroglossal duct cysts (LTGDCs) are rare congenital anomalies that necessitate proactive surgical intervention due to their potential for life-threatening airway obstruction. The challenging anatomical location of LTGDCs complicates their surgical management, and there are currently no standardized surgical modalities in place.ObjectiveTo analyze the clinical features of LTGDCs and evaluate the feasibility, safety, and efficacy of coblation-assisted transoral endoscopic excision of LTGDCs.DesignRetrospective case series (2009-2022) analyzing preoperative, intraoperative, and postoperative data.SettingTertiary academic center.ParticipantsTwenty-nine patients (20 males, 9 females; ages 3-70, with a median age of 34 years) were diagnosed with LTGDCs, including 7 (24.1%) with recurrent LTGDCs following prior surgeries at other institutions.InterventionCoblation-assisted transoral endoscopic excision of LTGDC using FK retractors and a 30° Hopkins telescope for optimal visualization and manipulation.Main Outcome MeasuresComplete cyst excision, postoperative recovery, recurrence rates, complications, and surgical feasibility.ResultsAll LTGDCs were completely excised. During the procedure, it was found that the LTGDCs abutted but did not adhere to the hyoid bone, which allowed for their dissection from the periosteum of the hyoid bone using coblation. Postoperative recovery was uneventful, with an average postoperative stay of 3.1 days (range 1-5 days). No complications, such as bleeding, infection, or airway obstruction, occurred. The mean follow-up period was 5.3 years (range 6 months to 12.4 years), with no recurrences observed during this time.ConclusionsCoblation-assisted transoral endoscopic excision is a reliable, effective, and minimally invasive approach for managing LTGDCs. It ensures complete removal with low recurrence and complication rates, aided by superior visualization and manipulation space provided by FK retractors and a 30° Hopkins telescope.RelevanceThis technique offers a safe alternative to traditional surgeries, reducing trauma and enhancing recovery. Future studies should explore comparisons with other surgical modalities to validate their broader applicability.