-
Anatomy & Cell Biology Feb 2024Comprehensive understanding of the variations in the branching of the external carotid artery (ECA) is essential to minimizing vascular complications during...
Comprehensive understanding of the variations in the branching of the external carotid artery (ECA) is essential to minimizing vascular complications during cranio-facial and neck surgical procedures. We demonstrate a rare case of unusual branching of ECAs in both carotid triangles and anomalous origin of the left ascending pharyngeal artery (APA) during dissection of embalmed cadaver. The right and left common carotid arteries (CCA) bifurcated at the level of the upper border of the thyroid cartilage. The right superior thyroid artery (STA) originated anterior to the carotid bifurcation (CB), while the left STA originated from the anterior aspect of the left CCA. The right ECA trifurcated into linguofacial trunk, APA, and distal ECA, 15.7 mm from CB. On the left side, lingual artery and APA arose as a short common linguopharyngeal trunk, 1.9 mm from CB. The left facial and occipital arteries originated anteromedially and posteriorly at the same level.
PubMed: 38415312
DOI: 10.5115/acb.23.302 -
Medicina (Kaunas, Lithuania) Feb 2024: Typically, the external carotid artery (ECA) sends off separate anterior branches: the superior thyroid, lingual, and facial arteries. These could, however, form...
: Typically, the external carotid artery (ECA) sends off separate anterior branches: the superior thyroid, lingual, and facial arteries. These could, however, form common trunks: thyrolinguofacial, linguofacial (LFT), or thyrolingual. Although known, the LFT variant was poorly detailed previously, and most authors just counted the variant. We aimed to demonstrate the individual anatomical possibilities of the LFT on a case-by-case basis. : 150 archived angioCT files were used. After applying inclusion and exclusion criteria, 147 files of 86 males and 61 females were kept for this study. : In 34/147 cases, LFTs were found (23.12%). Bilateral LFTs were found in 13/34 cases (38.24%) and unilateral LFTs in 21/34 (61.76%) cases. Forty-seven LFTs were thus identified and further studied for different variables. Regarding the vertical topography of LFT origin, type 1a (suprahyoid and infragonial) was found in 28 LFTs (59.57%), type 1b (suprahyoid and gonial) was found in eight LFTs (17.02%), type 3 (suprahyoid and supragonial) was found in two LFTs (4.25%), type 2 (hyoid level of origin) in eight LFTs (17.02%), and type 3 (infrahyoid origin) in just one LFT (2.12%). Types of the initial course of the LFT were determined: type I, ascending, was found in 22/47 LFTs; type II, descending, in 12/47 LFTs; and type III, transverse, in 13/47 LFTs. Regarding the orientation of the first loop of the LFT, 23/47 LFTs had no loop, 4/47 had anterior loops, 1/47 had a posterior loop, 5/47 had superior loops, 5/47 had inferior loops, and 9/47 had medial loops. The position of the LFT relative to the ECA was classified as medial, anterior, or antero-medial. An amount of 12/47 LFTs were anterior to the ECA, 22/47 were antero-medial, 10/47 were medial, 2/47 were inferior, and 1/47 was lateral. Regarding their general morphology, 23/47 LFTs had a rectilinear course, 22/47 had loops, and 2/47 were coiled. A case-by-case presentation of results further demonstrated the diversity of the LFT. : In conclusion, the morphology and topography of the LFT are individually specific and unpredictable. It can be anticipated case-by-case by surgeons on CT or MR angiograms.
Topics: Male; Female; Humans; Carotid Artery, External; Thyroid Gland; Tongue; Arteries; Liver Function Tests
PubMed: 38399578
DOI: 10.3390/medicina60020291 -
Scientific Reports Feb 2024This study aimed to assess the performance of arterial-spin labeling MRA (ASL-MRA) for visualizing the external carotid artery (ECA) branches in comparison with...
This study aimed to assess the performance of arterial-spin labeling MRA (ASL-MRA) for visualizing the external carotid artery (ECA) branches in comparison with time-of-flight MRA (TOF-MRA) and CT angiography (CTA). We retrospectively selected 31 consecutive patients, who underwent both MRAs and CTA, prior to the intra-arterial chemoradiotherapy (IACRT) for head and neck cancer. Four patients underwent IACRT bilaterally, so we analyzed 35 ECAs. Pseudo-continuous, three-dimensional ASL using a turbo field echo sequence was acquired. For the TOF-MRA and CTA, clinically used parameters were applied. Two observers evaluated each ECA branch with reference to the angiogram at the IACRT, using five-point scale, in consensus. Friedman test for multiple comparisons was applied. ASL-MRA and CTA better visualized the superior thyroid, lingual, facial, submental, transverse facial, and internal maxillary arteries (IMAs) better than TOF-MRA (p < 0.05). In addition, CTA was superior to ASL-MRA in visualizing only submental artery among these arteries (p = 0.0005). Alternatively, the ASL-MRA was superior for visualizing the middle meningeal artery (MMA) and IMA, compared to the CTA (p = 0.0001 and 0.0007, respectively). ASL-MRA was superior to the TOF-MRA and similar to the CTA in visualizing most of ECA branches. Furthermore, ASL-MRA can better visualize the periphery of MMA and IMA than CTA.
Topics: Humans; Carotid Artery, External; Spin Labels; Retrospective Studies; Magnetic Resonance Angiography; Arteries
PubMed: 38396152
DOI: 10.1038/s41598-024-55018-4 -
Journal of Cardiothoracic Surgery Feb 2024Ectopic thyroid tissue is a rare developmental abnormality involving aberrant embryogenesis of the thyroid gland during passage from the primitive foregut to the...
Ectopic thyroid tissue is a rare developmental abnormality involving aberrant embryogenesis of the thyroid gland during passage from the primitive foregut to the pretracheal position. The most frequent position is the base of the tongue (lingual thyroid); however, it has been described in other sites, such as the submandibular region, trachea, mediastinum, and subdiaphragmatic regions.Here, we report a case of an adenomatous goiter that developed in mediastinal thyroid tissue without any connection to the pretracheal thyroid gland.
Topics: Humans; Mediastinum; Neck; Goiter; Colloids
PubMed: 38378661
DOI: 10.1186/s13019-024-02574-5 -
Laryngoscope Investigative... Feb 2024To evaluate the efficacy and safety of radiofrequency ablation (RFA) for benign nonfunctional thyroid nodules or functional lingual thyroid gland in a pediatric...
OBJECTIVE
To evaluate the efficacy and safety of radiofrequency ablation (RFA) for benign nonfunctional thyroid nodules or functional lingual thyroid gland in a pediatric population.
METHODS
Four pediatric patients (four female; mean age 13.50 ± 4.04, range 8-17 years) with either benign thyroid nodules or mildly obstructive lingual thyroid glands were treated with RFA from 2020 to 2021 were evaluated. The inclusion criteria for RFA therapy were (i) age < 18 years; (ii) benign cytopathological results on ultrasound guided fine needle aspiration; (iii) pressure or pain symptoms caused by the thyroid nodules; (iv) dysphagia or obstruction caused by the lingual thyroid tissue; (v) follow up for >6 months with otolaryngology or endocrinology.
RESULTS
Two patients had benign non-functioning thyroid nodules and two had mildly obstructive functioning lingual thyroid glands. Mean follow up was 10.75 ± 4.79 months. Each patient underwent one RFA session with no complications. For the patients with thyroid nodules, there was >74% reduction in nodule size at last follow up with improvement in neck swelling and pain. For the patients with lingual thyroid glands, both did not have any other functional thyroid gland identified. Both had visible decrease in size of the gland as visualized transorally with improvement in dysphagia and obstructive symptoms when lying flat.
CONCLUSION
RFA is a safe and effective option for managing benign thyroid nodules and lingual thyroid glands in a pediatric patient population.
LEVEL OF EVIDENCE
4.
PubMed: 38362180
DOI: 10.1002/lio2.1198 -
Frontiers in Endocrinology 2023Ectopic thyroid gland (ETG) is an uncommon clinical condition, presenting various challenges and limitations in its regulate diagnosis and treatment currently. This...
BACKGROUND
Ectopic thyroid gland (ETG) is an uncommon clinical condition, presenting various challenges and limitations in its regulate diagnosis and treatment currently. This study aims to enhance our understanding of ETG and improve the strategies for its diagnosis and treatment.
METHODS
The retrospective single-center study was conducted, encompassing clinical data from ETG patients screened at our institution between 2013 and 2022. Patients were categorized based on the location of the disease, and follow-ups were performed on each.
RESULTS
This study included a total of 47 patients who were confirmed to hav confirmed to have ETG. Among them, we found 29 cases of accessory thyroid and 18 cases of aberrant thyroid. Furthermore, 42 cases exhibited the single ETG, while 5 cases displayed the double ETG. The distribution of the ETG was as follows: 20 were lingual, 10 were submandibular, 10 were lateral cervical, 4 were thoracic mediastinal, 1 was esophageal, and 7 were ovarian. Of these cases, 22 patients underwent surgery, 18 received thyroid hormone replacement therapy, and 7 were placed under observation. All patients were followed up for 59.4 (12-117) months. No significant abnormalities were detected at the conclusion of the follow-up period.
CONCLUSION
ETG is frequently observed in the head and neck, particularly in lingual. Accessory thyroid glands are commonly reported, with most cases being single ETG. Notably, these glands usually do not manifest specific clinical symptoms. Therefore, the appropriate and comprehensive examinations during the initial diagnosis are crucial to avoid misdiagnosis. Treatment should be individualized, and long-term follow-up is essential for managing ETG effectively.
Topics: Humans; Follow-Up Studies; Retrospective Studies; Thyroid Dysgenesis; Treatment Outcome; Thyroid Gland; Laryngoscopy; Magnetic Resonance Imaging; Tomography, X-Ray Computed
PubMed: 38075053
DOI: 10.3389/fendo.2023.1278734 -
Iranian Journal of Otorhinolaryngology Nov 2023Ectopic thyroid is an uncommon condition resulting from the aberrant development of the normal thyroid gland and is usually found along the thyroglossal tract: lingual,...
INTRODUCTION
Ectopic thyroid is an uncommon condition resulting from the aberrant development of the normal thyroid gland and is usually found along the thyroglossal tract: lingual, submandibular, thyroglossal cysts, intra-tracheal and mediastinal, or, on rare occasions, in the adrenal gland, gallbladder, gastrointestinal tract, pancreas, and struma ovarii.
CASE REPORTS
We describe a novel case where primary papillary thyroid carcinoma (PTC) was found after a trans-oral excision of a tumor containing ectopic thyroid tissue at the posterior pharynx, an area not known to be a location for ectopic thyroid. Delays due to the COVID-19 pandemic resulted in regional cervical metastases and multifocal PTC. The female patient successfully underwent total thyroidectomy, selective cervical and central lymph node dissection, followed by adjuvant radioactive iodine ablation, with no evidence of distant metastases.
CONCLUSIONS
Ectopic thyroid tissue is uncommon and may be in the posterior pharynx. The principles of management remain those of differentiated thyroid malignancy: complete surgical resection of any tumor focus, total thyroidectomy, and node dissection of involved lymph nodes, followed by adjuvant radioactive iodine in iodine-sensitive tumors.
PubMed: 38074483
DOI: 10.22038/IJORL.2023.73099.3471 -
Clinical Case Reports Dec 2023Whenever an enlarging mass is seen in throat, possibility of lingual thyroid should be considered. Thyroid function test should be done whenever ectopic thyroid is...
KEY CLINICAL MESSAGE
Whenever an enlarging mass is seen in throat, possibility of lingual thyroid should be considered. Thyroid function test should be done whenever ectopic thyroid is detected. Imaging (ultrasonography or Tc-99m scintigraphy) is adequate for diagnosis. Conservative treatment with levothyroxine helps in reducing size of lingual thyroid.
ABSTRACT
Hashimoto thyroiditis in lingual thyroid results in enlargement of the thyroid gland and oropharyngeal symptoms. Suppression therapy with levothyroxine results in reduction in size of the gland. We present an interesting case of Hashimoto disease in an adolescent female presenting as oropharyngeal mass.
PubMed: 38033679
DOI: 10.1002/ccr3.8273 -
Open Life Sciences 2023Ectopic thyroid is a rare malformation induced by a migration defect in the developing gland during embryogenesis. In 90% of cases, the ectopic thyroid is located in the...
Ectopic thyroid is a rare malformation induced by a migration defect in the developing gland during embryogenesis. In 90% of cases, the ectopic thyroid is located in the lingual region, whereas it is extremely rare in the abdominal cavity, particularly in the pancreas. A 50-year-old female patient presented to the Taizhou First People's Hospital with a complaint of recurrent mid-lower abdominal pain and diarrhea for approximately a month. The abdominal computed tomography scan revealed a space-occupying lesion with abundant blood supply in the head of the pancreas during the consultation. This led to the suspicion of a neuroendocrine tumor. The doctor considered that this lesion in the head of the pancreas could be responsible for the patient's incontinence. A laparoscopic pancreaticoduodenectomy was performed after relevant tests were undertaken and contraindications were ruled out. The patient was diagnosed with ectopic thyroid of the pancreas through postoperative pathology. Ectopic thyroid can be considered in middle-aged and elderly women who present with a mass with abundant blood supply and an unknown diagnosis. Subsequent treatments should be decided after fine-needle aspiration cytology.
PubMed: 37941786
DOI: 10.1515/biol-2022-0742 -
Folia Morphologica Oct 2023The anatomy of the external carotid artery and its variations are of ground significance in head and neck surgery. During a dissection of a male cadaver, an undescribed...
The anatomy of the external carotid artery and its variations are of ground significance in head and neck surgery. During a dissection of a male cadaver, an undescribed common trunk between superior thyroid, superior laryngeal, and lingual arteries was found. The variations of the anterior cervical branches of the external carotid artery and their clinical implications are discussed. The described unusual branching pattern of the external carotid artery must always be considered in invasive or non-invasive procedures because it may lead to unexpected complications.
PubMed: 37889221
DOI: 10.5603/fm.95862