Robot-assisted excision of thyroglossal duct cyst by a postauricular facelift approach

Bilateral axillo-breast approach robotic thyroglossal duct cyst resection in an adolescent: a case report and literature review

Background

Thyroglossal duct cyst (TGDC) is a common congenital neck mass that is the most frequent cause of neck swelling in children. The traditional open Sistrunk procedure for TGDC often leaves a visible scar on the neck. Therefore, it is essential to consider the impact of neck scarring on the quality of life for children and adolescents. Our study aimed to assess the safety and efficacy of robotic TGDC resection using the bilateral axillo-breast approach (BABA) in adolescents.

Case Description

A 16-year-old female patient presented with a neck mass (no pain or redness) that had been present for 3 years. The palpable neck mass moved with swallowing and there was no history of other significant medical conditions. An ultrasound scan of the neck indicated a weak hypoechoic area in the thyrohyoid region measuring 29 mm × 20 mm. Additionally, the ultrasonography of the thyroid gland showed no obvious abnormalities. A computer tomography (CT) scan confirmed a low-density lesion on the right hyoid bone, measuring 27 mm × 18 mm × 26 mm, consistent with a TGDC. We successfully performed a BABA robotic TGDC resection on the 16-year-old female adolescent who had a strong desire for scar-free surgery.

Conclusions

BABA robotic TGDC resection could achieve the same surgical effect as conventional open surgery while providing better cosmetic outcomes, which are essential for the physical and mental well-being of teenagers. Therefore, BABA robotic TGDC resection may be a safe and feasible treatment option with excellent cosmetic results in adolescents.

Retrospective comparison of endoscopic transoral and bilateral areolar approaches for thyroglossal cyst resection: a single-centre experience

PURPOSE

Our study aimed to compare the efficacy, safety, and clinical effect of the transoral approach and the bilateral areolar approach (BAA) for endoscopic thyroglossal duct cyst (TGDC) resection.

METHODS

In total, 42 patients who received an endoscopic TGDC resection between January 2019 and May 2022 via a transoral (n = 22) or bilateral areolar (n = 20) approach by a single surgeon were retrospectively enrolled. We collected and compared the following data: patients' demographic data, complication events, operative time, bleeding volume, drainage volume, 6-h postoperative pain scores, length of hospitalisation, resected TGDC size, and cosmetic satisfaction.

RESULTS

There were no cases of conversion to a transcervical approach in the two groups. No significant differences were found between the two groups in terms of age, sex, body mass index, complication, bleeding volume, 6-h postoperative pain scores, and TGDC size (all p > 0.05). However, the operative time and patients' cosmetic satisfaction were higher in the transoral group than in the BAA group (all p < 0.05). In addition, the drainage volume and length of hospitalisation in the transoral group were less than those in the BAA group (all p < 0.05).

CONCLUSIONS

Both the transoral approach and BAA are safe and reliable; however, the transoral approach is more complex than the BAA and offers better cosmetic satisfaction. Doctors should choose the appropriate surgical procedure based on the patient's condition and preferences.

Transoral endoscopic vestibular approach Sistrunk procedure: First reported case series

BACKGROUND

Standard of care for management of thyroglossal duct cysts (TGDCs) is a Sistrunk procedure performed through a transcervical incision. We describe the first series of Sistrunk procedures performed through a transoral endoscopic vestibular approach, eliminating a visible external scar.

METHODS

The transoral endoscopic vestibular approach to the Sistrunk (TEVAS) was performed in patients with TGDCs meeting inclusion criteria who desired a scarless approach.

RESULTS

Six patients (five females and one male) underwent TEVAS, with a mean age of 38 years (range 16-56 years) and a mean TGDC size of 1.8 cm (range 1.1-2.4 cm). Mean operative time was approximately 5 h (range 2-8 h). There were no surgical complications or recurrences.

CONCLUSIONS

For appropriately selected patients, the TEVAS is an alternative to open neck surgery that provides improved cosmesis while maintaining successful resection outcomes. More data on outcomes including complications and recurrences are needed as additional case information is collected.

OK-432 treatment of pediatric patients with recurrent thyroglossal duct cyst after surgery

&lt;b&gt;Introduction:&lt;/b&gt; Recurrent thyroglossal duct cyst after surgery is not a rare condition and first-line treatment has not been established yet.&lt;br/&gt;&lt;br/&gt; &lt;b&gt;Aim:&lt;/b&gt; Evaluation of outcomes and complications of OK-432 treatment in patients with recurrent thyroglossal duct cyst after surgery. &lt;br/&gt;&lt;br/&gt; &lt;b&gt;Material and methods:&lt;/b&gt; This study is designed as a case series with planned data collection at Tohoku Medical and Pharmaceutical University and Fukase Clinic. Five patients with recurrent thyroglossal duct cyst after surgery received this therapy between January 2014 and February 2020 on an outpatient basis, without hospitalization. OK-432 solution was injected into the lesion using an 18- or 27-gauge needle, depending on the location and size of the lesion, as well as on possible complications.&lt;br/&gt; &lt;br/&gt; &lt;b&gt;Results:&lt;/b&gt; Lesions showed marked reduction or total shrinkage in all patients, with no local scarring or deformity at the injection site. Side effects manifested as local pain at the site of injection and fever (37.5-38.5°C) observed in three patients, but the symptoms resolved within a few days.&lt;br/&gt; &lt;br/&gt; &lt;b&gt;Conclusions:&lt;/b&gt; Since OK-432 therapy is simple, easy, safe and effective, it can be used as an alternative to surgery in the treatment of recurrent thyroglossal duct cyst after surgery.

Management of Thyroglossal Cyst in Adults: A Single-Institution Experience

Objectives:

Thyroglossal duct cyst (TDC) is the most common congenital anterior neck mass in clinical practice. Due to its congenital origin, presentation in adulthood is uncommon with only 7% of cases presenting in this age group. Data are therefore limited on the management of TDC in adults, particularly in Sub-Saharan Africa. This study describes the pattern of the presentation and treatment outcomes, following the management of TDC in a series of adults in a Nigerian tertiary hospital.

Subjects and Methods:

A retrospective review of all adult patients with TDCs over a 5-year period was carried out. Sociodemographic data, operative details, and postoperative outcomes were obtained and presented as descriptive statistics.

Results:

Seven adult patients, including five males and two females, were managed during the period. Their ages ranged from 19 to 60 years, with a mean of 37 ± 16.4 years. All the patients presented with anterior neck swellings which had been present for a median duration of 3 years. Cysts were located in the infrahyoid position in all instances, and all had Sistrunk operation over a mean operative time of 78 ± 16 min. There were no intraoperative complications. The mean duration of the postoperative stay was 2 days. There was no recurrence after a median follow-up period of 15 months.

Conclusion:

This study highlights the rarity of TDC in adults and describes a single institution's experience with the management of adult cases of TDC using the classical Sistrunk operation.

Endoscopic-Assisted Transoral Thyroglossal Cyst Resection

Sistrunk procedure is the standard method for thyroglossal duct cyst resection. While this procedure is successful and safe, it results in postoperative scars on the front of neck. We propose a total transoral technique without external incision that starts with careful separation of the floor of the mouth and genioglossus muscle followed by the exact localization of the cyst using methylene blue. Simultaneously, the hyoid bone connected to the cyst and tract was removed. Finally, routine hemostasis is conducted, and the operative cavity is closed. All patients who received this operation in our department recovered successfully without experiencing severe intraoperative or postoperative complications.