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

Abstract

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. © 1998 John Wiley & Sons, Inc. Head Neck 20: 79–82, 1998.

Lingual Thyroid in Children: A Rare Clinical Entity

“…This can be accomplished with either preoperative tracheostomy or nasotracheal intubation. Both transoral and lateral pharyngotomy approaches have been described 28–31 . The mandible‐splitting technique has also been described to improve exposure of the transoral approach 32 .…”

Lingual Thyroid: A Systematic Review of Hormonal Suppression Treatment

“…In the group that had no improvement (31/80 or 38.7%), 12 patients were in a hypothyroid or compensated hypothyroid status (38.7%), 13 were euthyroid (41.9%) and six were of unknown hormonal status prior to treatment commencing. 15 ) with an overall mean of 22months. Montgomerry in 1935 reported a high rate of lingual thyroid among females compared to males.…”

Coblation assisted excision of lingual thyroid

“…Suppressive hormone therapy and radioactive iodine are the main medical treatment. Options for the surgical removal of LT include: Suprahyoid pharyngotomy to access to the posterior limits of the tumor, transoral exposure for direct dissection of the anterior margin of the lesion, transorally using a posterior midline tongue-splitting incision, peroral approach via a mandibular midline osteotomy, transoral median glossotomy or lesions may be approached either via the neck or transorally [7,9,18]. All of these procedures need tracheotomy or intensive cares unit for airway problem.…”

“…Treatment options includes: Surgical excision [3], transposition [4], radioiodine-131 therapy [5] and thyroid hormone replacement [6]. Surgical options for treatment of LT include tongue-splitting for trans-oral excision [7], preoral approach via a mandibular midline osteotomy [8], suprahyoid pharyngotomy [8], combined approach (Transoral and Transcervical approach) [9]. All of these approaches need tracheotomy and intensive care for airway.…”