Echographical manifestations of thyrolingual cysts

Purposes: Thyrolingual cysts (TLC) – not rare congenital cranio-facial pathology. TLC clinical symptoms usually require the differential diagnostics with different inflammatory processes and another kind of cysts and cystic lesions. Ultrasound (US) misdiagnoses may appears because of TLG various echographical manifestations.

Methods & materials: 238 patients from 2 days till 47 years with TLC were undergone standard clinical and ultrasound examination (child:adult=191:47=80,3%:19,7%; male:female=152:86=63,9%:36,1%; nonoperated:recurrenced=175:63=73,5%:26,5%). In 37 patients (15,5%) TLC were in the emptying stage (with functioning native drainage); in 140 patients (58,8%) – in filling stage (without functioning native drainage), in 61 patients (25,6%) – in suppuration stage. Clinical diagnoses and ultrasound data were verified surgically.

Results: Different solitary TLC variants was revealed in 95 patients (39,9%): parahyoid variant – in 44 patients (46,3%/18,5%); suprahyoid variant (radix linguae cyst) – in 13 patients (13,7%/5,5%), prehyoid variant – in 11 patients (11,6%/4,6%), infrahyoid variant – in 27 patients (28,4%/11,3%). Combined TLC variant with double or triple cysts were revealed in 143 patients (60,1%). In 173 patients (72,7%) TLC were associated with external (25 cases –14,5%/10,5%) and internal (148 cases –85,5%/62,2%) fistulas. Except usual and well-known echographical signs of cysts the following pathognomonic symptoms of TLC were detected: hyoid bone deformation (191 patients –80,3%), gas in cyst cavity (64 patients –26,9%).

Conclusion: Ultrasound examination is considered to be powerful instrument of TLC identification and of its individual clinically and surgically important features detection.