Management of Thyroglossal Duct Cysts After Failed Sistrunk Procedure (original) (raw)
Related papers
Journal of Clinical and Basic Research (JCBR), 2022
Background: Thyroglossal duct cysts (TGDCs) are the most common congenital cervical anomalies that account for about 2-4% of all midline neck swellings. They may present as a cyst, abscess, or sinus in the anterior neck region. The cysts are managed by the standard or a modified Sistrunk operation with the least chance of recurrence when compared to the removal of the cyst alone. This study aimed to present our experience in the modified Sistrunk operation over thyroglossal duct cyst anomalies with particular emphasis on the clinical diversity in presentation, surgical technique, and management of postoperative complications. Methods: This prospective observational study was carried out on 25 newly diagnosed cases of TGDC, which were confirmed histologically and radiologically over a period of 5 years. Results: All patients underwent a modified Sistrunk operation under general anesthesia and followed up for 2 years. The surgery consisted of complete excision of the cyst with the removal of the central portion of hyoid bone and macroscopically evident duct tissue with intraoperative T-shaped closure of the muscular layer to restore the function of hyoid bone and reduce most postoperative complications, such as recurrence and swallowing difficulties. Conclusion: The results indicate that the modified Sistrunk operation is one of the best surgical procedures for the treatment of TGDC anomalies limited up to hyoid without lingual extension, especially to prevent a recurrence. More attention should be paid to supra and infra hyoid muscular closure to restore the normal function of the hyoid.
Thyroglossal cyst our experience
Otolaryngology Online Journal, 2013
This study shares our experiences in managing patients with thyroglossal cysts. These are common midline tumors of neck. Characteristically these masses move on protrusion of tongue due to their intimate relationship with hyoid bone. Adults commonly presented with this lesion eventhough literature review suggests it to be common in children. All these patients underwent surgery because of the presence of mass rather than any symptoms. All 30 patients taken up in this study had a normal functioning thyroid in the normal position in addition to the cystic lesion.
Thyroglossal duct cyst - old and new surgical approach
Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i, 2021
The thyroglossal duct cyst (TDC) results from a failure in obliterating the embryogenic duct produced during thyroid migration and it represents the most common type of developmental cyst encountered in the neck region. Material and methods: In the First Surgical Clinic from "Sf. Spiridon" County Clinical Emergency Hospital Iasi, Iasi, between 1998 to 2021, 21 patients with thyroglossal duct cyst were diagnosed and treated. All medical recor ds were reviewed. Results: The thyroglossal duct cysts are located as midline cysts of the neck in all cases. The mean age was 39.2 years (13-66 years). The treatment performed was a variant of Sistrunk's procedure in which the thyroglossal tract was excised to a variable extent, with central hyoidectomy. The size of the cyst ranged from 1.2 to 4 cm (mean 2.6 cm). Postoper ative course was uneventful in all cases. No recurrence was recorded in this series. We d escribe a case, a 42 years old women, with asymptomatic mass in the anterior part of the neck found a 6 months before, when the patient was referred us with lithiasic obstructive jaundice (we performed ERCP + laparoscopic cholecystectomy). The treatment performed was a var iant of Sistrunk's procedure in which the thyroglossal tract was excised by minimally invasive video-assisted approach, variation of Miccoli's technique. Postoperative course was u neventful. The follow-up 1 and 2 years no recorded recurrence and thyroid scintigraphy was normal. Conclusions: The standard surgical approach to TDC is Sistrunk's operation with low recurrence rates. Although the results and the operative time are the same as in trad itional surgery, minimally invasive video-assisted approach has better cosmetic result and a less painful course.
Huge thyroglossal duct cyst in elderly patient: Case report
International journal of surgery case reports, 2018
Thyroglossal duct cyst is the most common congenital neck mass. About 50% of cases present before the age of 10. A second group present in young adulthood. We present a case of an 85 years old male patient who presented to us with a huge swelling occupying the whole front of the neck, matching the characters of a thyroglossal cyst by history and clinical examination. The swelling first appeared in early adulthood. He received faulty advice that led him to believe that the operation was too risky. He lived without treatment or complications except for very slow progressive enlargement of the swelling over the years until it became cosmetically very bad and interfering with his daily activities. The swelling was cystic, non-tender with surrounding healthy skin except small area showing minimal signs of inflammation. Neck US and (CT) confirmed the diagnosis of thyroglossal cyst, 92*76 mm in size. We performed surgical excision of the cyst, tract and central part of hyoid bone (Sistrunk...
The incidence of microscopic thyroglossal duct tissue superior to the hyoid bone
The Laryngoscope, 2018
Despite the success of the Sistrunk procedure, persistence of a thyroglossal duct cyst (TGDC), sinus, or remnant following excision remains a clinical problem. This is most likely due to the presence of microscopic disease that was not excised at the time of surgery. The purpose of this study is to determine the incidence of microscopic disease superior to the hyoid bone in children who have had either a primary or revision procedure for a TGDC. A prospective review of pathologic specimens was conducted of all consecutive patients undergoing TGDC excision by pediatric otolaryngologists at the Children's Hospital Los Angeles beginning March 2014 through July 2017 in both primary and revision procedures. Microscopic disease was present superior to the hyoid bone in 25 of the 34 (74%) specimens and in 100% (6) of the specimens from a revision procedure. The majority of persons who have a TGDC will have microscopic disease superior to the hyoid bone. In order to minimize the inciden...
Evaluation and management of a carcinoma arising in a thyroglossal duct cyst
American Journal of Otolaryngology, 1987
Thyroglossal duct remnants are the most common congenital cystic lesions of the neck; however, a carcinoma arising in these structures is rare. Two new cases of a papillary adenocarcinoma arising in a thyroglossal duct cyst are presented. Preoperative evaluation, operative management, and postoperative care are discussed. Initial evaluation consisting of a thorough head and neck examination, palpation of the thy(oid gland, thyroid funotion tests, and selective use of thyroid imaging is recommended. Removal of the cyst and tract in the manner described by Sistrunk is advocated. If an adenocarcinoma is found in the cyst and if a carcinoma is found in the thyroid gland or a thyroid scan reveals a nodule, a total thyroidectomy is recommended. A modified neck dissection and total thyroidectomy is advocated for cervical metastases. Postoperatively, thyroid suppression and long-term follow-up are encouraged. A squamous cell carcinoma arising in a thyroglossal duct remnant appears more aggressive and requires complete excision and, for confirmed cervical metastases, radical neck dissection and postoperative radiation therapy.