Transoral, minimally invasive, video-assisted technique for lingual thyroid

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Abstract

Introduction

Lingual thyroid is a rare developmental congenital anomaly. Symptoms may not develop unless the gland enlarges because of gland hypertrophy or malignancy. When removal is advocated, most proposed techniques are invasive and associated with substantial morbidity.

Materials and methods

The approval of the Otolaryngology Department Research and Ethics Committee, Mansoura University, to perform an analysis of a new minimally invasive surgical technique for the management of a case of obstructive lingual thyroid gland was obtained before study commencement. Careful preoperative assessment of the diagnosis of the lingual thyroid gland included an 131I scan and an MRI of the head and neck with and without gadolinium.

Results

A transoral, minimally invasive, video-assisted thyroidectomy, using Harmonic shears, was performed on a 22-year-old man with a longstanding lingual thyroid that had begun to cause dysphagia and upper airway obstruction. The procedural time was 85 min, and the estimated blood loss was 20 cm3. The patient tolerated a regular diet with minimal discomfort and was discharged home within 24 h.

Conclusion

The combination of the transoral endoscope-guided technique with Harmonic vascular control is considered a surgically minimally invasive satisfactory option in well-trained hands familiar with such tools.