Presentation, Management, and Outcome of Lingual Thyroglossal Duct Cyst in Pediatric and Adult Populations
Presentation, Management, and Outcome of Lingual Thyroglossal Duct Cyst in Pediatric and Adult Populations
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儿童和成人舌甲状舌管囊肿的表现、治疗和结果
DOI：
10.1097/scs.0000000000005522
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发表时间：
2019-07-01
影响因子：
0.9
通讯作者：
Bu，Rong-fa
中科院分区：
文献类型：
--
作者：
Li，Wei;Ren，Yi-peng;Bu，Rong-fa
舌甲状舌管囊肿是罕见的颈部先天性异常。作者通过2008年至2018年的回顾性观察分析，描述了儿童和成人LTDC的表现、管理和结果。数据包括患者的人口统计、主要主诉、术前调查、手术处理和复发情况。纳入17例患者：8例儿童，9例成人。最常见的症状是异物感（35.3%）。总的来说，50%（4/8）的儿童有呼吸问题，而成人最常见的症状是吞咽困难（8/9）。复发性LTDC 5例；3例患者怀疑会厌囊肿复发。总误诊率为35.3%(6/17)，其中儿童14.3%(1/7)，成人55.6%（5/9）。纤维喉镜检查显示ltdc主要发生在舌底（53.3%）和会厌瓣膜（33.3%）。超声检查示舌根低至无回声肿块；50%是规则形状，50%是不规则形状。所有儿童患者均为规则性肿块（100%），但大多数成人患者为不规则肿块（85.7%）。总的来说，76.5%的患者接受了Sistrunk手术，23.5%的患者只接受了有袋化。平均随访时间37.5±32.8个月。所有患者随访良好。总之，直接喉镜检查和超声检查对于诊断是必要的，因为ltdc可能与小室囊肿混淆。外科治疗，如有袋手术或Sistrunk手术必须彻底进行。
Lingual thyroglossal duct cysts (LTDCs) are rare congenital anomalies of the neck. The authors described the presentation, management, and outcome of LTDC in pediatric and adult cases through a retrospective observational analysis between 2008 and 2018. Data included patients’ demographics, main complaint, preoperative investigations, surgical management, and recurrences. Seventeen patients were included: 8 pediatric and 9 adult patients. The most common presenting symptom was foreign body sensation (35.3%). In all, 50%(4/8) of the children had respiratory problems, while the most common symptom in adults was difficulty swallowing (8/9). Five patients were of recurrent LTDC; 3 referred patients were suspected of having recurrent epiglottic cysts. The total misdiagnosis rate was 35.3%(6/17): 14.3%(1/7) in children and 55.6%(5/9) in adults. Fiber optic laryngoscopic examination revealed that LTDCs mostly occurred at the base of the tongue (53.3%) and vallecula epiglottica (33.3%). Ultrasound examination revealed low to anechoic masses on the root of the tongue; 50% were regular in shape and 50% were irregular. All pediatric patients had regular masses (100%), but most adults had irregular masses (85.7%). In total, 76.5% of the patients underwent the Sistrunk procedure, and 23.5% underwent marsupialization alone. The mean follow-up length was 37.5±32.8 months. All patients were well at follow-up. In conclusion, direct laryngoscopy and ultrasound examination are essential for diagnosis as LTDCs can be confused with vallecular cysts. Surgical treatment such as marsupialization or the Sistrunk operation must be performed thoroughly.