Electrocautery only for hyoid bone removal in pediatric thyroglossal duct cyst excision

Surgical excision of hyoid bone is the mainstay of thyroglossal duct cyst removal, to prevent recurrences. Bone excision by cut - bone forceps may prove inaccurate and somewhat dangerous. Therefore, use of alternative methods has been advocated.

The proposal of the study is to cut the body of the hyoid bone with the only electric scalpel. Surgical casenotes of 57 pediatric patients operated by our Institution with modified Sistrunk technique and complete dissection of the entire body of hyoid bone and its removal at the cartilage junction with lateral horn with monopolar cauterization were reviewed.

The population of our study had a mean age of 59.86 ± 29.57 months; 6/57 patients (10.5%) were under 2 years of age. Mean follow up was 55,04 ± 29,08 months ranging 2 to 115 months. In any patients post-operative bleeding was observed. Mean surgical time was 57,02 ± 11,77 minutes ranging from 35 to 125 minutes; 6 cases required postoperative drain. In 3 patients an immediate local edema was observed and in another one a partial wound dehiscence occurred, no late complications were observed. Cyst-recurrence requiring re-do surgery occurred in 5 patients (8.8%).

The complete hyoid bone section with electric scalpel only ensures the ideal access to the posterior hyoid space and allows a greater and more symmetrical access to the proximal portion of thyroglossal duct in children with still negligible complication and recurrence rate.

Modified Sistrunk technique, Sistrunk procedure, Thyroglossal duct cyst.