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Presentation, Management, and Outcome of Lingual Thyroglossal Duct Cyst in Pediatric and Adult Populations

Li, Wei MD; Ren, Yi-peng MD; Shi, Yue-yi MS; Zhang, Lei MD; Bu, Rong-fa MD

doi: 10.1097/SCS.0000000000005522
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Lingual thyroglossal duct cysts (LTDCs) are rare congenital anomalies of the neck. The authors described the presentation, management, and outcome of LTDC in pediatric and adult cases through a retrospective observational analysis between 2008 and 2018. Data included patients’ demographics, main complaint, preoperative investigations, surgical management, and recurrences. Seventeen patients were included: 8 pediatric and 9 adult patients. The most common presenting symptom was foreign body sensation (35.3%). In all, 50% (4/8) of the children had respiratory problems, while the most common symptom in adults was difficulty swallowing (8/9). Five patients were of recurrent LTDC; 3 referred patients were suspected of having recurrent epiglottic cysts. The total misdiagnosis rate was 35.3% (6/17): 14.3% (1/7) in children and 55.6% (5/9) in adults. Fiber optic laryngoscopic examination revealed that LTDCs mostly occurred at the base of the tongue (53.3%) and vallecula epiglottica (33.3%). Ultrasound examination revealed low to anechoic masses on the root of the tongue; 50% were regular in shape and 50% were irregular. All pediatric patients had regular masses (100%), but most adults had irregular masses (85.7%). In total, 76.5% of the patients underwent the Sistrunk procedure, and 23.5% underwent marsupialization alone. The mean follow-up length was 37.5 ± 32.8 months. All patients were well at follow-up. In conclusion, direct laryngoscopy and ultrasound examination are essential for diagnosis as LTDCs can be confused with vallecular cysts. Surgical treatment such as marsupialization or the Sistrunk operation must be performed thoroughly.

Department of Oral and Maxillofacial Surgery, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, China.

Address correspondence and reprint requests to Rong-fa Bu, MD, Department of Oral and Maxillofacial Surgery, Chinese PLA General Hospital. No. 28, Fuxing Road, Haidian District, Beijing 100853, China; E-mail: rongfabu@aliyun.com

Received 12 January, 2019

Accepted 19 February, 2019

This work was supported by the National Natural Science Foundation of China (No. 81760200), and the Natural Science Foundation of Inner Mongolia (No. 2017MS0326).

The authors report no conflicts of interest.

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© 2019 by Mutaz B. Habal, MD.