The value of using loupe magnification and methylene blue dye in intra-operative identification of thyroglossal duct tract

This was a comparative randomised study to find out the value of using loupe magnification and methylene blue dye in identification of the thyroglossal duct and to compare between them.

Twenty-two patients who presented with infrahyoid thyroglossal duct cyst were subjected to excision of the cyst with two methods for identification of thyroglossal duct track during the operation. Data were anlysed for identification of multiple tracts, the tract relation to the hyoid bone, incidence of complications and operative time.

We found that multiple tracts were present in 9.1% of the patients in Group I and 36.3% in Group II, with no statistically significant difference between the two groups. The incidence of complications was 27.2% in Group I and 9.1% in Group II, with no statistically significant difference between both groups. However, the incidence of identification of the tract, and its relation to the hyoid bone was higher in Group II (90.9%) than in Group I (45.5%) , with a statistically significant difference between both groups. Also the incidence of identification of the extension level of the tract above the hyoid bone and up to the tongue base was significantly higher in Group II (72.8%) as compared to Group I (9.1%). The operative time was significantly shorter in Group II (54.35 min) and was 76.55 min in Group I, (P = 0.0001).

Intra-operative identification of the thyroglossal tract is an essential step in the removal of the thyroglossal duct cyst. Both loupe magnification and methylene blue dye help in the tract identification, however, the usage of surgical loupes enhances better and safe results.