Efficacy of Ethanol Ablation for Thyroglossal Duct Cyst

Lee, Dong Kun; Seo, Ji Won; Park, Heon Soo; Kang, Myung Koo; Jang, Ae Lan; Lee, Joon‐Hyung; Hong, Jong Chul

doi:10.1177/0003489414542845

Cited by 23 publications

(35 citation statements)

References 12 publications

(31 reference statements)

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“…We used ethanol as the ablative agent because it is both readily available and inexpensive. Ethanol is a very caustic agent, and is used as an effective sclerosant in many clinical scenarios [ 17-20 ]. Ethanol destroys cells via dehydration, protein denaturation, coagulation, necrosis, small vessel thrombosis, haemorrhagic infarction, and reactive fibrosis [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Ethanol is a very caustic agent, and is used as an effective sclerosant in many clinical scenarios [ 17-20 ]. Ethanol destroys cells via dehydration, protein denaturation, coagulation, necrosis, small vessel thrombosis, haemorrhagic infarction, and reactive fibrosis [ 17 ]. After the initial inflammatory insult, damaged cells are replaced with connective tissue preventing regrowth [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous Salivary Gland Ablation using Ethanol in a Rat Model

Burch

Lubeley

Murakami

2017

JOMR

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ObjectivesSialorrhea is a common health and psychosocial problem for children with neuromuscular dysfunction secondary to a variety of disorders such as cerebral palsy. Current accepted treatments include the injection of botulinum toxin into the submandibular glands for temporary symptom relief. The purpose of this study is to demonstrate the feasibility of percutaneous ethanol injection for longer lasting salivary gland ablation in an animal model. Material and MethodsTwenty rats were used in this study. In each rat, 98% ethanol was injected into the right submandibular gland under ultrasound guidance. No intervention was performed on the left gland, which served as the control. Ten rats were sacrificed and glands evaluated at three weeks, with the remaining 10 rats sacrificed and evaluated at three months. Unpaired, 1-tailed T-tests were used to analyse the data.ResultsEthanol injections induced a significant and sustained reduction in salivary gland size. Treated glands were 41% smaller by mass than untreated controls in the 10 rats sacrificed at three weeks (P < 0.001). Treated glands were 43% smaller by mass than untreated controls in the 10 rats sacrificed at three months (P < 0.001). Qualitative histologic analysis demonstrated extensive parenchymal damage, inflammation, and fibrosis at both three week and three month time points.ConclusionsUsing a rat model, we demonstrated dramatic and sustained submandibular gland damage after percutaneous injection of ethanol.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Percutaneous Salivary Gland Ablation using Ethanol in a Rat Model

Burch

Lubeley

Murakami

2017

JOMR

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“…However, ever more radical resection of the tongue base risks fistula formation and injury to hypoglossal nerve branches. There are a few reports describing the use of injected sclerosing agents 32,33 or intraluminal electrodessication 34 to control recurrent disease. These have not been replicated in large series with long-term follow-up.…”

Section: The Suprahyoid Compartmentmentioning

confidence: 99%

Why Central Neck Dissection Works (and Fails) for Recurrent Thyroglossal Duct Remnants

Isaacson

Kaplon

Tint

2019

Ann Otol Rhinol Laryngol

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Objective: To review the patient characteristics and outcomes for children and undergoing central neck dissection for control of recurrent thyroglossal duct cysts and fistula following prior Sistrunk procedures and children requiring surgery for refractory infection. Methods: We performed a computerized review of all children who were evaluated for thyroglossal duct cysts during the years 1999-2018 by a single surgeon operating at an urban children’s hospital and an outpatient surgical center. Those requiring a central neck dissection for control of recurrent disease or intractable infection were identified. Age at time of surgery, sex, surgical procedure, and postoperative complications were recorded. These data were combined with similar data from a published report by the same surgeon in the years 1990-1998 to complete a 28-year review. Results: 18 central neck dissections were performed including 13 for recurrent thyroglossal duct remnants after Sistrunk procedures and 5 primary surgeries for intractable infection. Ages ranged from 3 to 19 years (median = 10 years) and 13 of 18 were girls (72%). Four children had their first Sistrunk surgery performed by the senior author. Three children operated elsewhere had intact hyoid bones at the time of revision surgery, suggesting less-than-Sistrunk primary surgeries. Central neck dissection controlled disease in the lower neck in all cases. One child re-fistulized at the level of the hyoid. Conclusions: Central neck dissection in combination with a Sistrunk-type dissection of the tongue base is effective in the control of recurrent infection following unsuccessful Sistrunk surgery and aids in dissection for children with intractable infection. Although this technique reliably controls infrahyoid disease and improves access to the hyoid and posterior hyoid space, it does nothing to address the difficulties of following the thyroglossal tract into the tongue base.

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“…The former imaging was performed with 1 of 3 US systems: an iU22 ultrasound machine (Philips Healthcare, Best, the Netherlands), Acuson S2000 (Siemens, Erlangen, Germany), or an EUB-7500 HV (Hitachi Medical Systems, Tokyo, Japan). All 3 were equipped with a high-frequency linear probe (5)(6)(7)(8)(9)(10)(11)(12)(13)(14). The index cyst volume was calculated as V ϭ abc / 6, where V is the volume, a is the largest diameter, and b and c are the other 2 perpendicular diameters.…”

Section: Preprocedural Assessmentmentioning

confidence: 99%

“…Therefore, minimally invasive treatment such as ultrasonography (US)-guided chemical ablation has been suggested as an alternative treatment for BCC. [2][3][4][5][6][7] Both chemical ablation with picibanil (OK-432) and ethanol ablation (EA) are widely used to treat cystic lesions of the neck and oral cavity, such as thyroid cyst, ranula, and lymphatic malformation, [8][9][10][11][12][13] but only a few studies have focused on the use of either treatment in BCCs. Since Fukumoto et al 2 initially used EA on 3 BCCs in 1994, several studies have reported success rates of roughly 60% in patients with BCC treated with OK-432.…”

mentioning

confidence: 99%