[Comparison between transoral minimally invasive surgery and Sistrunk surgery for the treatment of lingual thyroglossal duct cyst].

Abstract

Objective: To evaluate the feasibility and efficacy of transoral minimally invasive surgery for the treatment of lingual thyroglossal duct cyst(LTGDC) by comparison with Sistrunk surgery. Methods: The clinical data of 34 patients with LTGDC were analyzed retrospectively at the First Affiliated Hospital of Zhengzhou University from March 2019 to August 2023. Among these patients, comprising 26 males, 8 females, aged from 1 year and 11 months to 76 years old, with a mean age of 31 years old, 22 patients underwent transoral minimally invasive surgery and 12 patients underwent Sistrunk surgery. The operation time, intraoperative blood loss volume, recovery time and follow-up information of the two groups were analyzed. The follow-up period ranged from 12 to 65 months. An independent sample t-test was used to analyze the surgical duration between the two groups, while the Mann-Whitney U test was employed to analyze data on age, cyst size, intraoperative blood loss, and length of hospital stay between the two groups. Results: There were no significant differences in gender, age and size of the cysts between the two groups(all P>0.05). For the transoral minimally invasive group, the mean operation time was (75.5±20.2) minutes, median intraoperative blood loss volume was 5.0(5.0, 10.0)ml and median recovery time was 9.0(8.0, 10.0)days. The data of Sistrunk group were (131.7±16.8) min, 27.5(20.0, 40.0)ml, 11.0(10.0, 15.0)days respectively. There was a statistically significant difference between the two groups(Z=-8.192, -4.539, -3.71, all P<0.001). In the transoral group, there were three recurrences, two patients subsequently underwent Sistrunk surgery, while one opted for continuous observation. Additionally, one patient experienced partial loss of epiglottic cartilage.Four patients in the Sistrunk group developed a pharyngeal fistula, but there were no reported recurrences. Conclusions: Compared to Sistrunk surgery, transoral surgery for lingual thyroglossal duct cyst provides several benefits, such as reduced complication rates, accelerated recovery, and the absence of neck scarring.