颈外径路Sistrunk手术治疗成人复发性舌甲状舌管囊肿的临床分析

目的 探讨成人复发性舌甲状舌管囊肿（LTGDC）的临床特点、误诊原因及手术治疗。方法 回顾性分析2018年1月—2021年3月收治的6例反复复发的成年LTGDC患者，术前行甲状腺B超提示甲状腺位置并排除异位甲状腺，颈部CT检查明确肿物大小、部位及与舌骨的关系，喉咽部MRI明确肿物性质。手术均采用颈外径路Sistrunk手术。结果 6例患者曾误诊为会厌囊肿4例，舌根囊肿2例，均已行囊肿切除术，复发时间3周至1年。所有患者行颈外径路Sistrunk手术完整切除甲状舌管囊肿及瘘管，术后病理确诊为甲状舌管囊肿。术后随访1年以上无复发。结论 复发性舌根部或会厌间隙的囊性肿物应考虑LTGDC的可能性。所有患者术前均应行喉镜检查和颈部影像学检查以了解囊肿的形态、位置及其和舌骨的关系来选择手术方式。对于成人复发性LTGDC，Sistrunk手术可彻底切除囊肿减少复发。

Sistrunk surgery outcomes of recurrent lingual thyroglossal duct cyst in adults

Objective To explore the clinical features, reasons of misdiagnosis and surgical treatment of recurrent lingual thyroglossal duct cyst (LTGDC) in adults.Methods Clinical data of 6 adult patients with recurrent LTGDC enrolled from January 2018 to March 2021 were analyzed retrospectively. All patients underwent ultrasound B examination to determine the location of the thyroid, computed tomography (CT) and magnetic resonance imaging (MRI) scans to evaluate the size, location and property of the mass, as well as the relationship between the mass and hyoid bone. Sistrunk operation were performed for all patients.Results Four patients were misdiagnosed as epiglottic cyst while the other two patients were misdiagnosed as cyst of the lingual root. All patients had previously recieved operation for one to three times. The interval between each surgery and the following recurrence ranged from 3 weeks to 1 year. Thyroglossal duct cyst was confirmed by postoperative pathology in all cases. Postoperative follow-up over one year revealed no recurrence.Conclusion For the recurrent cyst located at the base of the tongue or in the preepiglottic space, LTGDC should be differentiated from the other cysts. Besides laryngoscopy, ultrasound B examination and CT scan should be performed to evaluate the morphology and position of the cyst and its relationship with the hyoid bone. Sistrunk surgery is the effective treatment for LTGDC to avoid the recurrence.