Anterior lingual thyroglossal cyst: antenatal diagnosis, management, and long-term outcome.
OBJECTIVE
To describe the long-term outcome of a large anterior lingual thyroglossal duct cyst, diagnosed antenatally by ultrasound that completely obstructed the oral cavity and had almost completely replaced the anterior two-thirds lingual musculature.


METHODS
Longitudinal observation.


RESULTS
Anticipated airway obstruction at birth did not occur. Complete cyst removal occurred at day 2 of life with a rim of lingual muscle observed present only on the left side. Complete and safe oral feeding was achieved by day 11 of life. Progressive muscle mass development and function with mild asymmetry was observed during sequential assessments. Vigorous speech therapy was started at age 7 months achieved 80-100% intelligible speech with minimal misarticulations at age 33 months.


CONCLUSIONS
This case demonstrates the remarkable compensatory ability of the tongue to achieve almost normal function with minimal anterior musculature that is critical to deglutition and articulation. Early speech therapy appears key to improving functional outcomes of speech. A strong central nervous system basis for suckle development is suggested by the rapid development of a safe and effective suckle and swallow soon after cyst resection and in spite of in utero tongue fixation.
Lindstrom
D Richard
DR
Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, 9000 West Wisconsin Avenue, P.O. Box 1997, Milwaukee, WI 53201, USA.
Conley
Stephen F
SF
Arvedson
Joan C
JC
Beecher
Robert B
RB
Carr
Margaret H
MH
D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008297:Male; D013070:Speech Therapy; D013955:Thyroglossal Cyst / Q000000981:diagnostic imaging* / Q000601:surgery* / Q000628:therapy; D014059:Tongue / Q000000981:diagnostic imaging / Q000473:pathology*; D014062:Tongue Neoplasms / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal