Purpose <p>Thyroglossal duct cyst (TGDC) management, particularly lingual variants, poses challenges in treatment due to its anatomical location and potential for recurrence. This study aims to introduce a novel technique for managing lingual TGDC, combining transoral laser microscopic excision with cauterization of the hyoid mid portion, to improve treatment efficacy and reduce recurrence rates.</p> Methods <p>The effectiveness of this approach was evaluated in 11 patients (age range: 2–16 years), including three cases with recurrent TGDC following simple transoral excision at other institutions. Procedures were performed under general anesthesia with meticulous attention to complete cyst removal and CO₂ laser cauterization of the hyoid bone.</p> Results <p>Patients experienced rapid postoperative recovery, and there were no instances of recurrence during a median 42-month follow-up period. The success of this technique suggests its potential as a standard approach for managing lingual TGDC.</p> Conclusion <p>The recurrence cases observed underscore the importance of adjunctive measures such as laser cauterization of the mid-portion of the hyoid bone in preventing recurrence. This highlights the significance of comprehensive management strategies in treating TGDC effectively.</p> Level of evidence <p>IV.</p>