100 Years of Progress From Sistrunk to Robot: Surgical Technique for Lingual Thyroglossal Duct Cyst

Author(s): Courtney Brooke Shires, Merry Sebelik

Objective: For thyroglossal duct (TGD) cysts which extend into the tongue base, or have had failed prior excision, exposure through the neck can be challenging. The aim of this study is to describe a case series of patients who underwent combined transcervical and transoral robotic surgery (TORS) to completely excise large or recurrent lingual TGD cysts.

Methods: Retrospective chart review of a case series of 5 adult patients who underwent combined Sistrunk and TORS approach to treat large or recurrent lingual TGD cysts at a tertiary care institution.

Results: 3/5 patients had undergone excision in the past, with cyst recurrence deep to the hyoid bone and extending into the tongue base. 2/5 had not had prior surgery, but the cyst was primarily within the tongue base. All patients underwent combined excision, with the TORS component completed first before the transcervical exposure. All patients required pharyngotomy by the nature and location of the TGD cyst, and all underwent primary closure through the neck incision. All healed well, resumed oral intake, and have demonstrated no recurrence in 2-year follow-up.

Conclusion: A combined transcervical and transoral approach is feasible and successful in treating the adult patient with large or recurrent lingual TGD cysts that have supra- and infrahyoid extension.