Transoral robotic excision of a lingual thyroglossal duct cyst

Abstract

Lingual thyroglossal duct cysts are a rare and potentially difficult to manage tongue base lesion. We report a case of transoral robotic surgical excision of a lingual thyroglossal duct cyst, in an adult patient. A 68-year-old man presented with a large base of tongue mass, with appearance on ultrasound and computed tomography consistent with a lingual thyroglossal duct cyst. We describe the surgical technique for transoral robotic excision of the cyst. The cyst was completely excised, and the patient had a smooth recovery. There has been no recurrence of the cyst. Transoral robotic surgery has several advantages over the conventional surgical approaches in the treatment of lingual thyroglossal duct cysts, including superior visualisation, and the ability of the robotic surgical system to manoeuvre instruments in a confined space. This enables complete excision, preventing recurrence of the cyst whilst also avoiding a neck scar.

Symptomatic Lingual Thyroglossal Duct Cyst in Children: A Laryngomalacia Phenotype

“…There are increasing reports of transoral robotic sistrunk procedures for lingual thyroglossal duct cysts. 12,14 It will be interesting to see if these procedures, which also violate the pharyngeal mucosa and involve resection of the central hyoid bone result in laryngeal destabilization or a laryngomalacia phenotype post-operatively.…”

“…Several techniques have been developed for management of such lesions, including transoral marsupialization, transoral excision via direct or endoscopic visualization, transhyoid suture-guided pharyngotomy, and transoral robotic excision. [10][11][12][13][14] Given the contents and superficial nature of vallecular cysts, endoscopic transoral marsupialization with varying techniques is an often-used approach with reports of good success and recurrence rates ranging from 0% up to 15%. 15,16 Endoscopic transoral marsupialization of lingual TGDCs have been described with success; however, this technique is associated with a higher rate of recurrence.…”

Estudio de caso de un quiste tirogloso lingual: una urgencia en la vía aérea del lactante menor

“…Los síntomas característicos del quiste tirogloso lingual varían desde síntomas respiratorios leves y disfagia hasta estridor persistente y distrés respiratorio secundario (3) a una obstrucción de la vía aérea, que puede poner en peligro la vida del paciente, como se demostró en nuestros pacientes (2,(5)(6)(7). Por esta razón, ante un lactante menor con dichos síntomas y luego de su estabilización y aseguramiento de la vía aérea según se requiera, proponemos una primera aproximación diagnóstica con una laringoscopia flexible, debido a su amplia disponibilidad y bajo costo.…”

Alternative Applications of Trans-Oral Robotic Surgery (TORS): A Systematic Review

“…Several articles have reported the description of trans-oral robotic removal of ectopic thyroid located at the tongue base [9]. Trans-oral removal of lingual thyroglossal cyst has also been presented, offering an alternative procedure to the conventional Sistrunk technique [10]. Other conditions have been mentioned as being treated by TORS, such as a salivary duct fistula at the level of posterior tonsillar pillar [11], schwannomas and vascular lesions of the tongue base, and even the removal of a foreign body embedded in the lingual tonsil [12,13].…”