Ezzat Abdelrahman E M, Eid Mustafa I, Akel Mabrouk M, El-Begermy Marwa M, Abbas Ayman Y
Department of ENT, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Department of Pediatric Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Afr J Paediatr Surg. 2016 Jul-Sep;13(3):140-4. doi: 10.4103/0189-6725.187815.
This was a comparative randomised study to find out the value of using loupe magnification and methylene blue dye in identification of the thyroglossal duct and to compare between them.
Twenty-two patients who presented with infrahyoid thyroglossal duct cyst were subjected to excision of the cyst with two methods for identification of thyroglossal duct track during the operation. Data were anlysed for identification of multiple tracts, the tract relation to the hyoid bone, incidence of complications and operative time.
We found that multiple tracts were present in 9.1% of the patients in Group I and 36.3% in Group II, with no statistically significant difference between the two groups. The incidence of complications was 27.2% in Group I and 9.1% in Group II, with no statistically significant difference between both groups. However, the incidence of identification of the tract, and its relation to the hyoid bone was higher in Group II (90.9%) than in Group I (45.5%) , with a statistically significant difference between both groups. Also the incidence of identification of the extension level of the tract above the hyoid bone and up to the tongue base was significantly higher in Group II (72.8%) as compared to Group I (9.1%). The operative time was significantly shorter in Group II (54.35 min) and was 76.55 min in Group I, (P = 0.0001).
Intra-operative identification of the thyroglossal tract is an essential step in the removal of the thyroglossal duct cyst. Both loupe magnification and methylene blue dye help in the tract identification, however, the usage of surgical loupes enhances better and safe results.
这是一项比较随机研究，旨在探究使用放大镜放大和亚甲蓝染料识别甲状舌管的价值，并对二者进行比较。
22例舌骨下甲状舌管囊肿患者在手术中采用两种方法识别甲状舌管路径后接受囊肿切除术。分析数据以确定多路径情况、路径与舌骨的关系、并发症发生率及手术时间。
我们发现，第一组患者中9.1%存在多条路径，第二组为36.3%，两组间无统计学显著差异。第一组并发症发生率为27.2%，第二组为9.1%，两组间无统计学显著差异。然而，第二组（90.9%）识别路径及其与舌骨关系的发生率高于第一组（45.5%），两组间有统计学显著差异。此外，第二组（72.8%）识别路径在舌骨上方直至舌根的延伸水平的发生率显著高于第一组（9.1%）。第二组手术时间显著更短（54.35分钟），第一组为76.55分钟，（P = 0.0001）。
术中识别甲状舌管路径是切除甲状舌管囊肿的关键步骤。放大镜放大和亚甲蓝染料均有助于路径识别，然而，使用手术放大镜能取得更好且安全的效果。
