Securing feeding tubes in head and neck surgery: Septal suture or bridle technique

Educational Objective: At the conclusion of this presentation, the participants should be able to describe the various presentations of a thyroglossal duct cyst (TGDC), to expand their differential diagnosis of a midline neck mass with dysphagia, acute voice change and shortness of breath, and to understand the acute treatment options for airway distress caused by a TGDC. Objectives: To present the unusual case of a patient with dysphagia, voice change, and shortness of breath who was found to have TGDC with intralaryngeal extension. The acute airway management and definitive surgical treatment options for the patient are discussed. Study Design: Retrospective review of a case record at a tertiary care medical center. Literature review using a PubMed search for TGDC with intralaryngeal extension. The reference sections of each of the relevant articles were also reviewed to find any additional pertinent studies. Results and Conclusions: A TGDC with intralaryngeal extension is a rare cause of dysphagia, hoarseness, and shortness of breath. The literature review shows only 11 previously reported cases. The acute management of this lesion is to manage airway. Our case demonstrates that needle aspiration of the cyst is a good alternative to intubation or tracheostomy. Definitive surgical intervention can be accomplished through a Sistrunk procedure with complete excision of the cyst and tract.