TGC

thyro glossal fistula and cyst

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                      common questions
1.Name age address occupation
2.Whats your sufferings
3.How long you are suffering from this
4.How it started
5.Is it painful at all
6.Is there any thing alike any where else
7.Does it go back/changes in size
8.Did you have any treatment before for this

9.family history

10.any other relevant query

 


 

There is a discharging sinus in mid line of front of the neck for 3 years
Who had a swelling at the same place since birth which became painful 5 years backand was operated/burst/incised mistakenly
On local examination sinus opening is @ the level of lower border of thyroid cartilage,
spherical in shape
Moves with deglutation and potrusion of tongue
There is mucoid discharge
Over lying skin condition is normal
There is hooding @ upper margin which becomes prominent while deglutation / potrusion of tongue
Local temparature not raised
Painless
Moves in all directions
But fixed on potrusion of tongue(TAG test +ve)

provisional diagnosis

TGF with external opening @ lowerborder of thyroid cartilage

differentials

TGC(ruptured)

 

other differentials of TGC

TGF
Cervical dermoid
Subhyoid bursitis
Ectopic thyroid(confirmed by 131I odine scan)
Solitary thyroid nodule
Enlarged LN

13.investigation

a.For confirmation of diagnosis

b.For detection of distant Extension
c.For diagnosis of Co morbidities/end organ damage

d.For Fitness

e.For follow up /prognosis

f.For planning

14.confirmatory diagnosis

15.treatment plan

• a.general management
• b.control of symptom
• c.control of co morbidities
• d.definitive management planning and execution

16.Follow up

17.cross

complications

Fistula
Recurrent infection
Papillary ca

Fate of TGD

Lower portion-isthmus+2 lobes
F/c to isthmus-disappear
Hyoid to isthmus-may persist

TGC charecters

Rounded
Well defined margin
Soft cystic
Fluctuation is positive
Transillumination negative

 

TGC

transillumination negative in TGC

tag test

sites of TGC

Base of tongue
Floor of mouth
submental

histopath of TGC

Tubulo dermoid
Lined by collumnar/cuboidal epithelium
Contains cholesterol crystal

 

 

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