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Treatment of Large Thyroglossal Duct Cyst PDF
Treatment of Large Thyroglossal Duct Cyst PDF
itself as a painless mass on the neck middle line, on the hyoid region
or slightly below it, and it can also be found on the thyroid duct performed without removal of the middle portion of the hyoid bone
embryological course.2 (Fig. 2A and B). A Penrose drain was put into surgical site through a
A 7-year-old patient, male, white, attended to the oral surgery little incision on skin of submental region, and was kept for
service complaining of dysphagia and dysphonia and showing 48 hours.
swelling on mouth floor with 6 years of evolution. During the Pathologic examination of the surgical specimen revealed cystic
clinical examination, it could be observed asymmetry of the lower capsule fragments lined by pseudostratified ciliated columnar
third of face, with a mobile mass in submandibular, sublingual, and showing squamous cell hyperplasia foci, and stratified epithelium
submental regions on the left side. The tongue was elevated (Fig. 1A
and C). The computerized tomographic scan revealed an extensive
lesion in neck region, which promoted the narrowing of the trachea
and its dislocation to the right side (Fig. 1B). The patient was
undergone to the incisional biopsy that indicated thyroglossal
duct cyst.
As a treatment form, it was performed a horizontal incision on
mouth floor between the Wharton duct outlet and womb of the
tongue, after that, the divulsion of muscle planes was carried out for
the exposition of the lesion (Fig. 1D). The removal of the lesion was
The Journal of Craniofacial Surgery Volume 00, Number 00, Month 2016 1
Copyright © 2016 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.
CE: D.C.; SCS-16-0460; Total nos of Pages: 2;
SCS-16-0460
Brief Clinical Studies The Journal of Craniofacial Surgery Volume 00, Number 00, Month 2016
areas not keratinized, agreeing with the diagnosis of thyroglossal permitted the complete removal of the lesion with no signs of
duct cyst. Currently, 03-year follow-up patient showed no recur- recurrence until this moment. However, a longer follow-up period is
rence signs or functional and aesthetic complaints (Fig. 2C and D). necessary to indicate patient’s cure.
Nakayam et al3 reported 2 patients of thyroglossal duct cyst in
floor mouth region.3 The patients were treated by intraoral approach
with no complications.3 According to the study performed by REFERENCES
Tristan et al2 a recurrence rate of 4.5% was seen during a fol- 1. Gioacchini FM, Alicandri-Ciufelli M, Kaleci S, et al. Clinical
low-up period varying between 7 months and 10 years.2 In the presentation and treatment outcomes of thyroglossal duct cysts: a
systematic review. Int J Oral Maxillofac Surg 2015;44:119–126
reported patient, it was not chosen the Sistrunk technique due to the
2. de Tristan J, Zenk J, Künzel J, Psychogios G, Iro H. Thyroglossal duct
lesion location; alternatively, the intraoral approach has shown cysts: 20 years’ experience (1992–2011). Eur Arch Otorhinolaryngol
itself practicable and, so far there have been no signs of recurrence. 2014;272:2513–2519
The most usual treatment for thyroglossal duct cyst has been the 3. Nakayam S, Kimachi K, Nakayama K, et al. Thyroglossal duct cyst
Sistrunk technique, but for the especial patients, as the reported one, occurring in the floor of the mouth: report of 2 cases. J Oral Maxillofac
the intraoral approach has shown to be technically feasible and has Surg 2009;67:2690–2693
Copyright © 2016 Mutaz B. Habal, MD. Unauthorized reproduction of this article is prohibited.