Micro-CT Imaging of Pediatric Thyroglossal Duct Cysts: A Prospective Case Series

The clinical characteristics and surgical strategy in infants with lingual thyroglossal duct cyst

OBJECTIVES

Lingual Thyroglossal Duct Cysts (LTDCs) are a rare variant of thyroglossal duct Cyst (LDC). This study aimed to explore the efficacy of transoral excision of LTDC and evaluate the added benefit of concomitant management of laryngomalacia during the surgical intervention.

METHODS

Infants with LTDCs were retrospectively collected from our department from January 2009 to January 2022. The baseline characteristics, clinical symptoms, the features of transnasal flexible fiberoptic laryngoscopy, CT and MRI, surgical treatments, and follow-up results were described and analyzed.

RESULTS

50 babies with LTDCs were included. Five infants had urgent bedside cyst aspiration prior to surgery for respiratory distress. All patients underwent cyst resection. Concurrent LTDC and laryngomalacia were found in 10 patients on preoperative laryngoscopy. Due to breathing and swallowing issues, these infants underwent transoral cyst removal and supraglottoplasty in the same surgical setting. 3 large cyst cases, laryngomalacia were undetectable pre-cystectomy. When extubation failed after 1weeks, repeat laryngoscopy revealed severe laryngomalacia necessitating successful supraglottoplasty. All patients were discharged from the hospital once oral intake is safe and adequate.

CONCLUSION

Transoral surgery for LTDC is an effective and safe surgical treatment. Additionally, identifying and promptly addressing other laryngeal conditions, such as laryngomalacia, significantly enhances the success rate of the surgery.

LEVEL OF EVIDENCE: 4

Pediatric bronchogenic cysts in the head and neck region: A study of 10 surgical cases and a review of the literature

OBJECTIVE

To explore the clinical characteristics and surgical treatment of children with bronchogenic cysts (BCs) in the head and neck region.

METHODS

A retrospective study of 10 pediatric patients with BCs in the head and neck region treated in Shanghai Children's Hospital during 2011 to 2022 was performed.

RESULTS

Based on their pathological diagnosis, 10 patients with BCs in the head and neck were identified. The most common location was the neck (8 patients, 80%; 2 midline neck, 6 lateral neck), followed by the ventral tip of tongue (1 patient), and the posterior pharyngeal wall (1 patient). Misdiagnosed as lymphangioma in 5 cases, cyst in 3 cases, thyroglossal duct cyst (TGDC) in 2 cases and congenital pyriform sinus fistula (CPSF) in 1 case preoperative. The median follow-up period after surgery was 4.68 (range, 0.67-9.25) years. All 10 patients underwent complete resection without recurrence or other complications.

CONCLUSIONS

Although extremely rare, BCs should be considered in the differential diagnosis of midline and lateral neck masses or intraoral cysts in children. Surgical excision is recommended in BCs, and the diagnosis is definitively confirmed by histopathology.