Transoral Endoscopic Resection Assisted by Radiofrequency Plasma Ablation for Lingual Thyroglossal Duct Cysts: A Retrospective Evaluation of Feasibility, Safety, and Outcomes

Ear Nose Throat J. 2026 Feb 25:1455613261427158. doi: 10.1177/01455613261427158. Online ahead of print.

Abstract

Background: Lingual thyroglossal duct cysts (LTGDCs) are rare, and there is no clinical consensus on the use of transoral endoscopic resection assisted by radiofrequency plasma ablation for their treatment.

Objective: To evaluate the feasibility, safety, and perioperative outcomes of transoral endoscopic assisted by radiofrequency plasma ablation resection for LTGDCs.

Materials and methods: We reviewed 17 patients aged 34 ± 12 years (range 12-61) who underwent transoral endoscopic resection assisted by radiofrequency plasma ablation for LTGDCs over 5 years. The procedure involved endoscopic exposure, circumferential dissection, cyst dome resection, fluid evacuation, multi-angle ablation, and cervical compression-aided ablation. Operative time, blood loss, complications, feeding recovery, and recurrence rates were analyzed.

Results: All procedures were completed endoscopically, without conversions to open surgery or tracheostomy. The mean operative time was 75.0 ± 31.2 minutes, and the average intraoperative blood loss was 28.0 ± 9.2 mL. All patients resumed liquid diets on postoperative day 3 and semiliquid diets by day 5. No severe complications occurred. Over a 2 to 40 months follow-up, the recurrence rate was 29.4% (5/17).

Conclusions and significance: Transoral endoscopic resection assisted by radiofrequency plasma ablation is a feasible and safe option for LTGDCs, with favorable cosmetic outcomes. However, the higher recurrence rate may limit its broader clinical applicability.

Keywords: endoscopy; lingual cyst; radiofrequency plasma ablation; scarless surgical procedures; thyroglossal duct cyst.