Drainage Post-TGD Remnant Surgery: Source and Analysis

• Published in: Otolaryngology-head and neck surgery 2008-08, Vol.139 (2), p.P64-P64
• Main Authors: Bakar, Saraiza Abu, Mankarious, Leila A., Martinez-Alvernia, Efrain A.
• Format: Article
• Language: English
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1016/j.otohns.2008.05.206

Objective Mucopurulent drainage following thyroglossal duct remnant (TGD) surgery can occur in spite of meticulous technique. We hypothesize that there may be some patients whereby the drainage is due to transected, normal salivary tissue located within the posterior tongue base, close to the hyoid. 1) To establish the distance between tongue base salivary tissue and hyoid. 2) To identify tissue-specific markers of TGD remnants as well as salivary tissue in order to distinguish drainage source. Methods Pilot study/tertiary care facility. The anterior neck block was obtained from 10 adult cadavers with no known TGD remnant. The distance between the normal salivary tissue and hyoid was measured. Immunohistochemistry (IHC) was performed on 5 archived tissue blocks from pediatric patients with post-Sistrunk mucopurulent drainage to identify the presence of amylase and MUC 7 (a mucin specific to salivary tissue) within the excised specimen. Results Average distance between salivary tissue and the hyoid within cadavers was 3.3mm (range 1.0–4.2mm). IHC revealed all 5 excised TGD remnants contained amylase; however, none (2 specimens with high background signal) contained MUC 7. Both amylase and MUC 7 were present within adjacent salivary tissues. Conclusions Normal salivary tissue of the tongue base normally resides an average of 3.3mm from the hyoid within the adult. Preliminary IHC indicates that MUC 7 may be a sensitive and tissue-specific marker of drainage due to transected salivary tissue. Testing for amylase does not appear to provide any tissue-specific information as to the source of post-Sistrunk mucopurulent drainage.