OP74 – Suture guided transhyoid pharyngotomy for recalcitrant lingual thyroglossal duct cysts in children

      Kim, William1; Crawford, Kayva2; Vecchiotti, Mark3; Scott, Andrew3 1 Department of Otolaryngology- Head and Neck Surgery, Tufts Medical Center, Boston, MA, USA 2 Tufts University, School of Medicine, Boston, MA, USA 3 Floating Hospital for Children at Tufts Medical Center, Pediatric Otolaryngology and Facial Plastic Surgery, Boston, MA, USA   Background/Purpose: In rare occasions a thyroglossal duct cyst (TGDC) may present in the base of tongue resulting in a lingual TGDC. Successful treatment of a TGDC requires complete initial surgical extirpation, or would otherwise risk recurrence thereby making subsequent resections more difficult with a high failure rate. Due to its location, lingual TGDC have demonstrated a surgical challenge in the pediatric population. We describe our experience with suture guided transhyoid pharyngotomy for recurrent lingual TGDC in children. Methods: A retrospective chart review of three cases at an urban tertiary medical center was performed. Clinical, radiographic, and operative data were collected and reviewed. A literature search of lingual TGDC and its management was performed. Results: Three patients ages ranging 2 to 17 presented with recurrent lingual TGDCs. All cases were treated via suture guided transhyoid pharyngotomy. Follow-up duration ranged from 7-29 months. No recurrence has been documented to date. All patients have been symptom free. Discussion: Suture guided transhyoid pharyngotomy first described in 2006 is a reliable surgical method for recurrent TGDC or lingual TGDC. Other surgical options have been described as well including endoscopic transoral marsupialization or excision, TORS, and transcervical wide tongue base removal. In our experience, suture guided transhyoid pharyngotomy provided adequate exposure, with minimal morbidity, low complication rates, and excellent results. Conclusion: Recalcitrant lingual TGDC can be treated by several methods including suture guided transhyoid phayngotomy.   References:
    1. Perkins JA, Inglis AF, Sie KC, Manning SC. Recurrent thyroglossal duct cysts: a 23-year experience and a new method for management, Ann Otol Rhinol Laryngol. 2006; 115: 850-856.


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