Laryngo fiberscopy-guided suspension procedure for an ectopic lingual thyroid obstructing airway
Abstract Background Currently, there is no consensus regarding the optimal therapeutic strategy for the management of an ectopic lingual thyroid. A surgical approach is suggested when airway obstructive symptoms cannot be tolerated at all, or when bleeding or malignancy occurs. However, for patients...
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| Language: | English |
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Japan Surgical Society
2018-09-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-018-0531-3 |
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| author | Tsubasa Aiyoshi Toshihiro Muraji Isho Izumi Miki Toma Kazuto Suda Toshihiro Yanai Kouji Masumoto |
| author_facet | Tsubasa Aiyoshi Toshihiro Muraji Isho Izumi Miki Toma Kazuto Suda Toshihiro Yanai Kouji Masumoto |
| author_sort | Tsubasa Aiyoshi |
| collection | DOAJ |
| description | Abstract Background Currently, there is no consensus regarding the optimal therapeutic strategy for the management of an ectopic lingual thyroid. A surgical approach is suggested when airway obstructive symptoms cannot be tolerated at all, or when bleeding or malignancy occurs. However, for patients in whom ectopic thyroid is the only functioning thyroid tissue, complete surgical excision needs to be followed by lifelong hormone replacement therapy. We report the case of an infant with ectopic lingual thyroid obstructing the airway that was treated using our novel surgical procedure. Case presentation A 10-day-old male infant presented with symptoms of airway obstruction and subclinical hypothyroidism. Imaging tests revealed an ectopic lingual thyroid and the absence of a normal pretracheal thyroid gland. We administered oral levothyroxine to lower his thyroid stimulating hormone (TSH) level and reduce the volume of the lingual mass; however, his airway symptoms did not improve. Subsequently, we performed a surgical intervention when he was 2 months old. We split the hyoid bone, and then suspended the lingual thyroid by suturing it to the hyoid bone to elevate the epiglottis. We confirmed the degree of suspension using intraoperative laryngo fiberscopy. After the surgery, the symptoms of airway obstruction were resolved and the patient was clinically euthyroid on low-dose oral levothyroxine. Conclusions Our laryngo fiberscopy-guided suspension procedure can be an effective surgical procedure for the treatment of ectopic thyroid. This relatively simple surgical procedure could completely preserve the patient’s thyroid tissue and resolve airway obstruction. |
| format | Article |
| id | doaj-art-0ff4b5cc9dfd420dbe35068a9db0faa4 |
| institution | DOAJ |
| issn | 2198-7793 |
| language | English |
| publishDate | 2018-09-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-0ff4b5cc9dfd420dbe35068a9db0faa42025-08-20T02:44:42ZengJapan Surgical SocietySurgical Case Reports2198-77932018-09-01411510.1186/s40792-018-0531-3Laryngo fiberscopy-guided suspension procedure for an ectopic lingual thyroid obstructing airwayTsubasa Aiyoshi0Toshihiro Muraji1Isho Izumi2Miki Toma3Kazuto Suda4Toshihiro Yanai5Kouji Masumoto6Department of Pediatric Surgery, Ibaraki Children’s HospitalDepartment of Pediatric Surgery, Ibaraki Children’s HospitalDepartment of pediatrics, Ibaraki Children’s HospitalDepartment of Pediatric Surgery, Ibaraki Children’s HospitalDepartment of Pediatric Surgery, Ibaraki Children’s HospitalDepartment of Pediatric Surgery, Ibaraki Children’s HospitalDepartment of Pediatric Surgery, Faculty of Medicine, University of TsukubaAbstract Background Currently, there is no consensus regarding the optimal therapeutic strategy for the management of an ectopic lingual thyroid. A surgical approach is suggested when airway obstructive symptoms cannot be tolerated at all, or when bleeding or malignancy occurs. However, for patients in whom ectopic thyroid is the only functioning thyroid tissue, complete surgical excision needs to be followed by lifelong hormone replacement therapy. We report the case of an infant with ectopic lingual thyroid obstructing the airway that was treated using our novel surgical procedure. Case presentation A 10-day-old male infant presented with symptoms of airway obstruction and subclinical hypothyroidism. Imaging tests revealed an ectopic lingual thyroid and the absence of a normal pretracheal thyroid gland. We administered oral levothyroxine to lower his thyroid stimulating hormone (TSH) level and reduce the volume of the lingual mass; however, his airway symptoms did not improve. Subsequently, we performed a surgical intervention when he was 2 months old. We split the hyoid bone, and then suspended the lingual thyroid by suturing it to the hyoid bone to elevate the epiglottis. We confirmed the degree of suspension using intraoperative laryngo fiberscopy. After the surgery, the symptoms of airway obstruction were resolved and the patient was clinically euthyroid on low-dose oral levothyroxine. Conclusions Our laryngo fiberscopy-guided suspension procedure can be an effective surgical procedure for the treatment of ectopic thyroid. This relatively simple surgical procedure could completely preserve the patient’s thyroid tissue and resolve airway obstruction.http://link.springer.com/article/10.1186/s40792-018-0531-3Ectopic thyroidLingual thyroidAirway obstructionSurgeryTransposition |
| spellingShingle | Tsubasa Aiyoshi Toshihiro Muraji Isho Izumi Miki Toma Kazuto Suda Toshihiro Yanai Kouji Masumoto Laryngo fiberscopy-guided suspension procedure for an ectopic lingual thyroid obstructing airway Surgical Case Reports Ectopic thyroid Lingual thyroid Airway obstruction Surgery Transposition |
| title | Laryngo fiberscopy-guided suspension procedure for an ectopic lingual thyroid obstructing airway |
| title_full | Laryngo fiberscopy-guided suspension procedure for an ectopic lingual thyroid obstructing airway |
| title_fullStr | Laryngo fiberscopy-guided suspension procedure for an ectopic lingual thyroid obstructing airway |
| title_full_unstemmed | Laryngo fiberscopy-guided suspension procedure for an ectopic lingual thyroid obstructing airway |
| title_short | Laryngo fiberscopy-guided suspension procedure for an ectopic lingual thyroid obstructing airway |
| title_sort | laryngo fiberscopy guided suspension procedure for an ectopic lingual thyroid obstructing airway |
| topic | Ectopic thyroid Lingual thyroid Airway obstruction Surgery Transposition |
| url | http://link.springer.com/article/10.1186/s40792-018-0531-3 |
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