To present a rare case of lingual thyroid detected using a hybrid of single photon emission computed tomography and standard computed tomography in a young woman with hypothyroidism.

A 29-year-old woman was screened for autoimmune thyroid disorders in early pregnancy, and found to have subclinical hypothyroidism. No thyroid tissue was found in the anterior neck upon ultrasonography, raising suspicions of an ectopic thyroid. The patient was treated with levothyroxine throughout the remainder of her pregnancy, and developed postpartum thyroiditis requiring an increase in levothyroxine dosage. Whole-body scintigraphy and zoomed static head and neck scintigraphy were performed. Abnormal 99mTc-pertechnetate uptake was observed in the oral region, whereas no uptake was found in the usual thyroid location. Hybrid imaging using single photon emission computed tomography and standard computed tomography was performed to improve three-dimensional representation of the area of increased activity.

The latter imaging modality detected ectopic thyroid tissue in the tongue.

Whole body 99mTc-pertechnetate scintigraphy and a hybrid of single photon emission computed tomography and standard computed tomography are effective imaging modalities for the investigation of ectopic thyroid tissue. The latter modality is particularly recommended, as it allows more precise spatial visualisation of increased isotope uptake activity in the head and neck.

A laryngocoele is an abnormal dilatation of Morgagni's ventricle in direct communication with the laryngeal lumen. Surgical excision through a cervical approach is traditionally considered the treatment of choice for large (external and mixed) laryngocoeles. This paper describes the first reported case of a large mixed laryngocoele treated with transoral robotic surgery without cervical incisions.

A 69-year-old female underwent transoral robotic surgery for the excision of a large mixed left laryngocoele. The surgery was performed using the da Vinci S surgical robotic system (Intuitive Surgical, Sunnyvale, California, USA).

No complications were observed and the patient was discharged 2 days post-operation.

Transoral robotic surgery enabled accurate dissection with complete removal of the large mixed laryngocoele via a minimally invasive approach. The advantages of transoral robotic surgery over other techniques for laryngocoele excision are discussed.

To describe the management of a 15-year-old girl with repeated life-threatening complications of her tracheostomy secondary to muscle dystonia and thoracolumbocervical lordosis.

This paper reports a retrospective case review.

Regular microlaryngoscopy and bronchoscopy, treatment with systemic steroids and a soft tracheostomy tube, in addition to better control of the dystonia, resulted in control of the patient's airway. This minimised tracheal inflammation and granulation tissue formation.

The need for a tracheostomy in patients with thoracolumbocervical lordosis and severe dystonia should be considered only after all other options of airway management have been explored. Every attempt should be made to minimise tracheal trauma caused by excessive movement of a tracheostomy tube.