舌根部甲状舌管囊肿的诊断与治疗

Diagnosis and treatment of atypical thyroglossal cyst

目的探讨发生于舌根部的非典型甲状舌管囊肿的临床表现、诊断和治疗方法。方法回顾分析4例发生于舌根部的甲状舌管囊肿患者的临床资料,手术采用支撑喉镜下激光切除术和颈外径路Sistrunk术。结果咽部异物感、咽部阻塞感是发生于舌根的甲状舌管囊肿的主要临床表现;颈部超声和CT检查是明确诊断的主要检查方法。支撑喉镜下激光手术无一例外均导致囊肿复发,3例复发1次,1例复发3次,颈外径路Sistrunk术将囊肿完整切除。结论发生于舌根的甲状舌管囊肿应常规行颈部超声和CT检查,以明确诊断;治疗首选颈外径路Sistrunk术式。

OBJECTIVE To study the manifestation, diagnosis and treatment of the atypical thyroglossal cyst in the base of tongue. METHODS Four patients with thyroglossal cyst in the base of tongue were reviewed. Presenting symptoms and treatment were analyzed retrospectively. All the patients underwent operation. RESULTS Foreign body and obstruction sensation of pharynx was the major symptom for thyroglossal cyst in the base of tongue. Ultrasonic examination and CT scanning were the methods to make correct diagnosis. Transoral endoscopic laser resection of the cyst resulted in recurrence. Three patients recurred once and one patient recurred 3 times. Recurrent cysts were completely removed with transcervical Sistrunk procedure. CONCLUSION Ultrasonic examination and CT scanning are the basic screening tools for the diagnosis of thyroglossat cyst in the base of tongue and Sistrunk operation is the ideal procedure for the complete removal of the thyroglossal cyst in the base of tongue.