PMC4555932_01
Incision
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F1
Surgical excision was planned under general anesthesia, we choose lip split [Figure 1] mandibulotomy procedure because this approach would provide a good wide exposure to base of tongue and also suspicion of a vascular tumor was not ruled out, miniplates were adapted and osteotomy cuts were done in the parasymphysis region in an oblique fashion [Figure 2] mylohyoid muscle was dissected and mandible was swung outward, to reach the base of the tongue, growth was exposed [Figure 3] and removed in toto [Figures 4 and 5].
Oblique bone cuts
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F2
Surgical excision was planned under general anesthesia, we choose lip split [Figure 1] mandibulotomy procedure because this approach would provide a good wide exposure to base of tongue and also suspicion of a vascular tumor was not ruled out, miniplates were adapted and osteotomy cuts were done in the parasymphysis region in an oblique fashion [Figure 2] mylohyoid muscle was dissected and mandible was swung outward, to reach the base of the tongue, growth was exposed [Figure 3] and removed in toto [Figures 4 and 5].
Tumor exposed
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F3
Surgical excision was planned under general anesthesia, we choose lip split [Figure 1] mandibulotomy procedure because this approach would provide a good wide exposure to base of tongue and also suspicion of a vascular tumor was not ruled out, miniplates were adapted and osteotomy cuts were done in the parasymphysis region in an oblique fashion [Figure 2] mylohyoid muscle was dissected and mandible was swung outward, to reach the base of the tongue, growth was exposed [Figure 3] and removed in toto [Figures 4 and 5].
Tumor excised
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F4
Surgical excision was planned under general anesthesia, we choose lip split [Figure 1] mandibulotomy procedure because this approach would provide a good wide exposure to base of tongue and also suspicion of a vascular tumor was not ruled out, miniplates were adapted and osteotomy cuts were done in the parasymphysis region in an oblique fashion [Figure 2] mylohyoid muscle was dissected and mandible was swung outward, to reach the base of the tongue, growth was exposed [Figure 3] and removed in toto [Figures 4 and 5].
Surgical defect
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F5
Surgical excision was planned under general anesthesia, we choose lip split [Figure 1] mandibulotomy procedure because this approach would provide a good wide exposure to base of tongue and also suspicion of a vascular tumor was not ruled out, miniplates were adapted and osteotomy cuts were done in the parasymphysis region in an oblique fashion [Figure 2] mylohyoid muscle was dissected and mandible was swung outward, to reach the base of the tongue, growth was exposed [Figure 3] and removed in toto [Figures 4 and 5].
Mandible repositioned and plated
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F6
The osteotomized mandible was repositioned and plated [Figure 6] and primary closure was achieved [Figure 7].
Final closure
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F7
The osteotomized mandible was repositioned and plated [Figure 6] and primary closure was achieved [Figure 7].
Excised specimen
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F8
Excised specimen was sent for histopathology [Figure 8].
Histopathology shows thyroid follicles lined by columnar cells with eosinophilic colloid inside the follicles
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F9
Histopathology report confirmed the diagnosis of lingual thyroid [Figure 9].