Lingual thyroid: a new surgical approach--a case report

Tongue Base Ectopic Thyroid Tissue-Is It a Rare Encounter?

Failure in the embryological development of the thyroid in adults is rarely seen. We present the case of a 79-year-old female patient who complained of dysphagia and progressive upper respiratory obstruction, which started 12 months prior to her admission. An ENT clinical exam revealed a tongue base, spherical, well-defined tumour covered by normal mucosa. Further assessments established the diagnosis of the tongue base ectopic thyroid tissue. Due to the patient's symptoms, a transhyoid tongue base tumour removal was performed. The selected patient gave consent for participation and inclusion in this paper, in compliance with the 1964 Helsinki declaration.

Transoral robotic excision of ectopic lingual thyroid: Case series and literature review

BACKGROUND

Surgical excision of an ectopic lingual thyroid has traditionally been associated with significant morbidity and has therefore been reserved for patients with severe obstructive symptoms or suspected malignancy. Transoral robotic surgery (TORS) has provided a minimally invasive approach to completely and safely excise ectopic lingual thyroid.

METHODS

Three index cases were identified from the detailed clinical database of TORS patients. A systematic review of the management of ectopic lingual thyroid in the English literature was performed.

RESULTS

TORS-assisted excision of a lingual thyroid gland was successfully performed in 3 patients with excellent functional outcomes

CONCLUSION

TORS-assisted excision of an ectopic lingual thyroid is a safe and feasible treatment modality with minimal morbidity, and, in experienced hands, should be offered as a valid treatment for this pathology.

A new minimally invasive lingual thyroidectomy technique

BACKGROUND

The lingual thyroid is uncommon, and the need for resection of this condition is even more rare. Techniques for removal have historically included wide access with associated disfiguring incisions. We sought to describe a minimally invasive and safe technique for the management of the obstructive lingual thyroid gland that achieves optimal hemostasis with the use of technology.

METHODS

Institutional Review Board approval was obtained to evaluate the safety and efficacy of a minimally invasive technique to remove the obstructive lingual thyroid gland. The procedure is performed in ∼1 hour; requires no splitting of the lip, tongue, or mandible, is associated with negligible blood loss, and is accomplished on an outpatient basis.

RESULTS

The procedure was undertaken in a 34-year-old woman with a longstanding lingual thyroid that began to cause dysphagia. She was found to be clinically and biochemically euthyroid, and was referred for surgical intervention. The procedural time was 90 minutes, and the estimated blood loss was 15 mL. She was discharged shortly after recovery, on an outpatient basis.

CONCLUSIONS

A number of surgical approaches to the obstructive lingual thyroid have been described, including the use of a lip-split, tongue-split, mandibulotomy, and cervical pharyngotomy approach. We describe a minimally invasive transoral procedure that incorporates Harmonic technology and high-resolution endoscopy and is accomplished with no external incisions on an outpatient basis.

Coblation assisted excision of lingual thyroid

Lingual thyroid (LT) tissue is the most frequent ectopic location of the thyroid gland. We report 5 cases of symptomatic LT and discuss the new surgical approach. Transoral approach and coblation assisted excision of LT was performed. Postoperative follow-up for all patients was like as tonsillectomy management without tracheotomy. It's seem that this approach is much better than other such as tongue-splitting, transcervical transhyoid, pharyngotomy, with an infrahyoid approach, combined cervical and intraoral approach, Mandibular midline osteotomy.

Transposition of the lingual thyroid: A new alternative technique

BACKGROUND

In symptomatic lingual thyroid, surgical transposition of the gland with its vascular supply intact seems to have superior results to those obtained by surgical ablation and autotransplantation. However, the procedure should be simple, reproducible, reliable, and cause less morbidity as well as providing simple access to and evaluation of the gland postoperatively.

METHODS

We present the case of a 33-year-old female with lingual thyroid who was treated by transposing the whole gland to the lateral pharyngeal wall through a lateral pharyngotomy incision. The transposed lingual thyroid was nourished by a random tongue muscle pedicle flap.

RESULT

At the 5-month postoperative stage, iodine scanning reviewed the radioactivity uptake of the transposed gland. Even though the patient was not on postoperative thyroid hormone supplement, her thyroid function gradually returned to normal after initially showing hypothyroid postoperatively.

CONCLUSION

This new technique for transposition of lingual thyroid is simple and reliable and should be considered as an alternative method in the management of symptomatic patients.

Combined cervical and intraoral approach to lingual thyroid: a case report

BACKGROUND

Lingual thyroid is a rare anomaly that may require surgical intervention. Lesions have been approached either via the neck or transorally. Advantages and limitations exist with each technique.

METHODS

A 10-year-old female on long-term suppression therapy for lingual thyroid developed progressive dysphagia; surgical excision was performed. Suprahyoid pharyngotomy was used to dissect the posterior limits of the tumor. Resection was completed via a transoral approach.

RESULTS

Cervical exposure allowed safe access to the posterior tumor margins. Transoral exposure permitted direct dissection of the anterior margin of the lesion, rendering complete excision simple.

CONCLUSION

A combined surgical approach to lingual thyroid is a safe technique that affords excellent visualization and facilitates resection.