Transoral robotic excision of thyroglossal duct cyst using vestibular and sublingual incisions

With the extension of remote-access head and neck surgery to improve postoperative cosmetic outcomes, a robotic or endoscopic procedure was developed to excise thyroglossal duct cysts (TGDCs). Here, we present the operative procedure of a novel transoral robot-assisted Sistrunk operation using oral vestibular and sublingual incisions in a 21-year-old woman with TGDC. A 1.5-cm central vestibular incision and two lateral vestibular incisions were made. In addition, a midline vertical sublingual incision was made to cut the hyoid bone via the sublingual route. The surgery was successfully completed without conversion to the conventional transcervical approach. Our technique using three vestibular incisions and a sublingual incision was more efficient in performing the Sistrunk operation than frenulotomy or endoscopic vestibular approaches. In conclusion, the transoral robotic Sistrunk operation using three vestibular incisions and a sublingual incision is feasible and safe and yields excellent postoperative cosmesis.