Lingual thyroid: tongue-splitting incision for transoral excision

Area of Science:

• Endocrinology
• Otolaryngology
• Head and Neck Surgery

Background:

• Lingual thyroid is a rare congenital anomaly where thyroid tissue is located in the tongue.
• Ectopic thyroid tissue can lead to airway obstruction and other symptoms.
• Diagnosis often involves imaging to confirm the location and function of the ectopic tissue.

Purpose of the Study:

• To report on two cases of symptomatic lingual thyroid.
• To describe a modified transoral surgical approach for lingual thyroid excision and reimplantation.
• To review the literature on lingual thyroid management.

Main Methods:

• Case presentation of two patients with symptomatic lingual thyroid.
• Iodine-131 (I131) thyroid scanning to assess functional thyroid tissue.
• Computed Tomography (CT) scanning to evaluate the size and obstruction caused by the lingual thyroid.
• Transoral excision of the lingual thyroid using a posterior midline tongue-splitting incision.
• Reimplantation of the excised thyroid tissue into the rectus abdominis muscle.

Main Results:

• Both patients had lingual thyroid as their only functional thyroid tissue.
• CT scans revealed large ectopic thyroids causing significant mechanical obstruction.
• Successful transoral excision and reimplantation were performed.
• The modified tongue-splitting approach facilitated the surgery.

Conclusions:

• Symptomatic lingual thyroid can cause significant obstruction requiring surgical intervention.
• Transoral excision with reimplantation is a feasible surgical option.
• The described modified tongue-splitting incision is effective for this procedure.