Heterotopy
of thyroid tissue ñ A modified therapeutical approach
by JaromÌr Astl, Jan Betka & Petr Vlcek
Submitted:
May 20, 2001
Accepted: July 21, 2001
Abstract:
OBJECTIVES: The authors describe the classification of
heterotopic thyroid tissue. A survey of more than 600 literature
cases is provided. Different therapy approaches for these
anomalies are discussed. Data from seven subsequent cases
have been added to the existing literature data. The authors
present an alternative approach to the therapy of heterotopic
thyroid tissue.
MATERIALS
AND METHODS: The records of seven patients treated for a heterotopy
of the thyroid tissue at the Department of ENT and Head and
Neck Surgery of First Medical school of the Charles University
of Prague since 1.1.1991 to 1.1.2001 have been analyzed.
RESULTS:
The first group: No surgery. This approach was used for
children. In these patients the heterotopic thyroid tissue
is the only thyroid tissue they have, but it’s function
is not damaged and there are no mechanical symptoms (no airway
obstruction and dysphagia). TSH substitution-suppression therapy
is necessary for this group. Co-operation and follow up by
the endocrinology, otolaryngology and pediatric departments
is necessary. At a later age these patients can be treated
as in the second group.
The second group: Surgery. All patients in this group
had heterotopic thyroid tissue. The total removal of thyroid
tissue has been preferred. Carcinomatous change or the development
of mechanical syndrome, dysphagia or airway obstruction is
possible. Total removal is the best surgical approach. Various
surgical methods are described in the literature (CO2
laser, intraoral, mandibulotomy, middle hyotomy etc.). These
patients are treated as after total thyroidectomy and substitution
therapy with synthetic thyroid hormones is necessary. The
authors describe and add seven cases to the literature data.
The authors describe radical removal of aberrant and accessory
tissue.
