Endoscopic combined with FK retractors-assisted transoral coblation excision of lingual thyroglossal duct cysts

Lingual thyroglossal duct cysts (LTGDCs) are a rare variant of thyroglossal duct cysts (TGDCs) with significant surgical challenges due to their special anatomical location at the base of the tongue. This retrospective case series aimed to evaluate the feasibility, safety, and efficacy of 30° endoscopic combined with FK retractors-assisted transoral coblation excision of LTGDCs. A retrospective analysis was performed on 6 consecutive patients diagnosed with LTGDCs who underwent the above surgical procedure at the First Affiliated Hospital of Chongqing Medical University from January 2023 to June 2025. The surgical approach involved exposing the tongue base and epiglottis with FK retractors under visualization with a 30° endoscope. The cyst was resected along its margin using plasma coblation down to the level of the hyoid bone, with subsequent ablation of its attachment site. Clinical data, examination findings, surgical parameters, and outcomes were collected and analyzed. All 6 patients successfully underwent endoscopic combined with FK retractors-assisted transoral coblation excision of LTGDCs. The median operation time was 55 min (range, 42–65 min), and the median amount of bleeding was 7.5 ml (range, 3–20 ml). A soft diet was initiated on the first postoperative day for all patients, and the median length of postoperative hospitalization was 4 days (range, 3–6 days). No postoperative complications were observed (Clavien-Dindo grade 0), and no airway compromise or swallowing difficulties occurred. During a median follow-up of 15 months (range, 6–30 months), no clinical or radiologic recurrence was detected, and all preoperative symptoms were significantly improved. 30° endoscopic combined with FK retractors-assisted transoral coblation excision of LTGDCs is feasible and safe for the treatment of LTGDCs in this small case series. Complete resection of the cyst to the hyoid bone level and ablation of the attachment site can achieve good short-term outcomes. • 30° endoscope combined with FK retractor ensures clear exposure and sufficient space at the tongue base. • Plasma coblation for resection and hemostasis enables precise excision with minimal tissue damage, less bleeding and faster postoperative recovery. • Ablating cyst pedicle on hyoid bone instead of resection avoids trauma, reduces recurrence. • The transoral endoscopic coblation resection demonstrates a low recurrence rate, and offers aesthetic and minimally invasive advantages.