Lingual thyroid in adults: management algorithm based on swallowing outcomes.
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
OBJECTIVE: To review the presentation, workup, and functional outcomes of adult patients diagnosed with lingual thyroid treated by transoral subtotal excision. These results were then used to formulate a management algorithm. DESIGN: Retrospective chart review (2001-2008). SETTING: Tertiary care academic hospital. PATIENTS: All patients diagnosed with a lingual thyroid as an adult were identified in the University of Alberta's head and neck mass database. Charts were reviewed for initial presentation, diagnostic methods, radiographic findings, and treatment and follow-up results. INTERVENTION: Transoral subtotal excision of lingual thyroid tissue. MAIN OUTCOME MEASURE: Postoperative swallowing function as measured by pharyngeal residue and aspiration on videofluoroscopic swallowing studies. RESULTS: Five patients with lingual thyroids meeting the study criteria were identified. All were females aged 29 to 58 years (mean 44 years). Presentations ranged from asymptomatic to acute airway obstruction. Diagnosis was made with flexible nasopharyngoscopy, thyroid scintigraphy, and computed tomography. All patients underwent transoral subtotal excision of their thyroids with either a CO2 laser or electrocautery. Two patients complained of residual symptoms and received adjunctive 131I, which led to symptom resolution. Pathologic evaluation revealed benign thyroid tissue. Swallowing function remained efficacious and safe in all patients, as shown by a lack of aspiration and low pharyngeal residue scores. These results were used to propose a management algorithm for the spectrum of adult-diagnosed lingual thyroid presentations. CONCLUSIONS: Transoral subtotal excision of lingual thyroid glands provides adequate resection of the lesion with good postoperative swallowing function. When appropriate, this is advocated as the treatment modality of choice.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it