A 27-year-old man presented with a painless, non tender, sublingual mass that had gradually increased in size and discharging sebaceous material at the tip of tongue. Since he had a tongue tie associated with it, this severely impaired his speech and swallowing. A CT Scan was done with contrast injected thru the sinus clearly shows a sinus tract leading to a midline cyst.
Lingual midline dermoid cysts of the tongue are uncommon. Lingual dermoid cysts most commonly present in early childhood or adolescence and are located in the anterior two thirds of the tongue. Lingual dermoid cysts are squamous epithelial-lined cavities with variable numbers of skin adnexae in the capsule and are rare entities in the head and neck.
The cyst was excised using the CO2 laser thru a median sagittal glossotomy approach. The tongue tie was also released at the same time using Co2 Laser. I think the midline sagittal glossotomy incision using the CO2 laser offers surgical precision, superior haemostasis and wound healing and minimal post-operative edema.