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Thyroglossal duct cysts, remnants from thyroid development, were analyzed in 124 patients. The Sistrunk procedure yielded a 6.4% recurrence rate, higher in infected cases.
Area of Science:
- Embryology
- Pediatric Surgery
- Otolaryngology
Context:
- Thyroglossal duct cysts (TDCs) are congenital anomalies resulting from incomplete obliteration of the thyroglossal duct.
- These cysts represent epithelial remnants during the thyroid's embryonic descent.
- Understanding TDC origins is crucial for effective surgical management.
Purpose:
- To analyze clinical, operative, and pathological findings in patients undergoing thyroglossal duct cyst excision.
- To evaluate the efficacy and recurrence rates associated with the Sistrunk procedure for TDC removal.
- To characterize the histopathological features and common locations of thyroglossal duct cysts.
Summary:
- A retrospective analysis of 124 patients (6 months to 72 years) treated for thyroglossal duct cysts.
- All patients underwent the Sistrunk procedure, including hyoid bone resection.
- Overall recurrence rate was 6.4%, significantly higher (3.5x) in infected cysts or those with a skin fistula. 20% of cysts were located off-midline. No malignancies were observed.
Impact:
- The study highlights the Sistrunk procedure's effectiveness in managing thyroglossal duct cysts.
- Identifies factors, such as infection and fistula, that increase recurrence risk.
- Provides insights into the varied histopathology and locations of these common congenital neck masses.
Abstract:
Thyroglossal duct cysts are embryologic anomalies arising from epithelial remnants of the duct left after the descent of the developing thyroid. Clinical, operative and pathological findings in 124 patients operated on in the past 14 years were analyzed. There were 60 males and 64 females. 69 (56%) were under 10 years of age and the youngest was 6 months old. 26 (21%) were over the age of 30, and the oldest was 72 years old. All excisions were performed in accordance with the Sistrunk procedure, which includes removal of the body of the hyoid bone. Overall recurrence was 6.4%, but in infected cysts or cysts with a fistula to the skin, it was 3.5 times greater. In 20% the cyst was located off the midline. The lining of the cysts was cuboidal, columnar, pseudostratified or stratified squamous epithelium, and varied according to the location of the cyst. There were no malignant changes.