Excision of tongue base lesions in children: The frenuloplasty mini-rake technique

Objectives

We developed a new approach of exposing the tongue base using frenuloplasty and mini-rakes (FMR) to resect lesions directly with microbipolar cautery. The purpose of this study is to review the patients who underwent this procedure at our center.

Methods

A medical chart review was conducted from January 2011 to June 2023 looking for children under 18 years of age who had a base of tongue lesion resected using the FMR technique. Age at time of surgery, lesion type, intubation, number of days until eating, and length of hospital stay were recorded.

Results

We identified 16 patients who underwent excision of a tongue base lesion using the FMR technique. The median (IQR) age was 1.9 (0.9–7.9) years. The diagnosis on pathology of the lesions were 13 lingual thyroglossal duct cysts, 1 lingual thyroid goiter, 1 dermoid cyst and 1 vallecular cyst excised. Nine (57 %) patients were extubated immediately after the procedure on the operating table, 6 (38 %) were extubated on the first postoperative day, and 1 (6 %) was extubated on the second postoperative day. The median (IQR) number of days until starting a normal oral diet was 1.0 (0–1.0) and the median (IQR) length of hospital stay was 2.5 (1.8–3.3) days. There were no complications from this technique.

Conclusion

Excision of tongue base lesions is feasible in children using the FMR technique. This may obviate the need for suspension microlaryngoscopy and laser resection and decrease risks associated with that technique.