Thyroglossal duct cysts: experience from a series of cases treated in the Oral and
Maxillofacial Surgery Clinic of General Hospital “G.Papanikolaou’’ in Thessaloniki,
Greece
Theodoros Grivas1 , Ioannis Pappas3 , Nikoleta Pastelli2 , James Philip Skliris2, Konstantinos Paraskevopoulos1, Konstantinos Vaxtsevanos1
1. Oral and Maxillofacial Surgery Clinic, G.Papanikolaou General Hospital in Thessaloniki(Director Professor Konstantinos Vaxtsevanos).
2. Pathology Department, G. Papanikolaou General Hospital in Thessaloniki.
3. Dental School, Aristotle University of Thessaloniki.
DOI:DOI:https://dx.doi.org/10.54936/haoms2411524
SUMMARY: Thyroglossal duct cyst is the most common swelling of fetal origin in the cervix, located predominantly in the frontal neck area. The prevalence of the disease is 7%, while in bibliography there is some controversy regarding the age of diagnosis, since some authors find greater occurrence in children and others in adults.[1-3] Clinically, it usually appears as a mobile, painless mass without tension most commonly located below the hyoid bone (75% of the patients), but if inflammated, it can be accompanied by pain. The indicated therapeutic approach of thyroglossal duct cysts is surgical removal under general anesthesia according to Sistrunk technique, that ensures the full removal of the cyst’s wall including part of the hyoid bone body with which it is usually attached. The aim of the present study which was written based on SCARE 2020 protocol according to EQUATOR[4]is the presentation of a series of 5 cases which were surgically treated in the University Clinic of Oral and Maxillofacial Surgery of G.Papanikolaou General Hos-pital in a 2.5 years time frame(9/2019-2/2022). Four of the patients were men(80%) (mean age 50.5 years, ranging from 36 to 71 years old) and one was a 63 year old woman(20%). All of the patients presented in the outpatient unit of the clinic with a painless mobile neck mass, that appeared euthyroid from the laboratory tests. All of the patients underwent surgical removal of the thyroglossal duct cyst and part of the hyoid bone at the same time (Sistrunk procedure). No regression was
noticed in the frequent postoperative follow-up. In conclusion, thyroglossal duct cyst is a clinically evident entity which although is more often diagnosed
and treated surgically in childhood, it can also appear in adults. It may be complicated with inflammation and appear as a painful neck swelling. The treatment of choice is surgical removal according to Sistrunk procedure.
KEY WORDS: Thyroglossal cyst, adult patients, surgical removal, case series
REFERENCES:
1. Lin, S.-T., et al., Thyroglossal duct cyst: a comparison between children and adults. American Journal of Otolaryngology, 2008. 29(2): p. 83-87.
2. Brousseau, V.J., et al., Thyroglossal duct cysts: presentation and management in children versus adults. Int J Pediatr Otorhinolaryngol, 2003. 67(12): p. 1285-90.
3. Allard, R.H., The thyroglossal cyst. Head Neck Surg, 1982. 5(2): p. 134-46.
4. Agha, R.A., et al., The SCARE 2020 Guideline: Updating Consensus Surgical CAse REport (SCARE) Guidelines. International Journal of Surgery, 2020. 84: p. 226-230.
5. Amos, J. and C. Shermetaro, Thyroglossal Duct Cyst, in StatPearls. 2022, StatPearls Publishing Copyright © 2022, StatPearls Publishing LLC.: Treasure Island (FL).
6. Brewis, C., et al., Investigation and treatment of thyroglossal cysts in children. 2000. 93(1): p. 18-21.
7. Sistrunk, W.E., THE SURGICAL TREATMENT OF CYSTS OF THE THYROGLOSSAL TRACT. Ann Surg, 1920. 71(2): p. 121-122.2. 8. Rohof, D., et al., Recurrences after thyroglossal duct cyst surgery: Results in 207 consecutive cases and review of the literature. Head Neck, 2015. 37(12): p. 1699-704. 9. de Tristan, J., et al., Thyroglossal duct cysts: 20 years’ experience (1992-2011). Eur Arch Otorhinolaryngol, 2015. 272(9): p. 2513-9. 10. Pelausa, M.E. and V. Forte, Sistrunk revisited: a 10-year review of revision thyroglossal duct surgery at Toronto’s Hospital for Sick Children. J Otolaryngol, 1989. 18(7): p. 325-33.
11. Ahmed, J., et al., The extended Sistrunk procedure for the management of thyroglossal duct cysts in children: how we do it. 2011. 36(3): p. 271-275.
12. Perkins, J.A., et al., Recurrent Thyroglossal Duct Cysts: A 23- Year Experience and a New Method for Management. 2006. 115(11): p. 850-856.
13. O’Neil, L.M., et al., Wide anterior neck dissection for management of recurrent thyroglossal duct cysts in adults. J Laryngol Otol, 2016. 130 Suppl 4: p. S41-4.
14. El-Anwar, M.W. and A.A. Nofal, Thyroglossal duct cyst excision with hyoid bone preservation. Eur Arch Otorhinolaryngol, 2016. 273(6): p. 1521-6.
15. Ryu, Y.-J., et al., Modified Sistrunk operation: New concept for management of thyroglossal duct cyst. International Journal of Pediatric Otorhinolaryngology, 2015. 79(6): p. 812-816.
16. Koempel, J.A., Thyroglossal duct remnant surgery: A reliable, reproducible approach to the suprahyoid region. International Journal of Pediatric Otorhinolaryngology, 2014. 78(11): p. 1877-1882.
17. Patel, N.N., B.E.J. Hartley, and D.J. Howard, Management of thyroglossal tract disease after failed Sistrunk’s procedure. Journal of Laryngology and Otology, 2003. 117(9): p. 710-712
18. Michael K, K.I.M., P. Bruce R, and I. Glenn, Central neck dissection for the treatment of recurrent thyroglossal duct cysts in childhood. Otolaryngology - Head and Neck Surgery, 1999. 121(5): p. 543-547.
19. Kim, J.P., J.J. Park, and S.H. Woo, No-Scar Transoral Thyroglossal Duct Cyst Excision in Children. Thyroid, 2018. 28(6): p. 755-761.
20. Kim, C.-H., et al., Robot-assisted Sistrunk operation via a retroauricular approach for thyroglossal duct cyst. 2014. 36(3): p. 456-458.
21. Kayhan, F.T., et al., Transoral surgery for an infant thyroglossal duct cyst. International Journal of Pediatric Otorhinolaryngology, 2013. 77(9): p. 1620-1623. 22. Byeon, H.K., et al., Robot-Assisted Sistrunk’s Operation, Total Thyroidectomy, and Neck Dissection via a Transaxillary and Retroauricular (TARA) Approach in Papillary Carcinoma Arising in Thyroglossal Duct Cyst and Thyroid Gland. Annals of Surgical Oncology, 2012. 19(13): p. 4259-4261.
23. Burkart, C.M., et al., Update on endoscopic management of lingual thyroglossal duct cysts. 2009. 119(10): p. 2055-2060.
24. Fong, S., et al., Transoral robotic excision of a lingual thyroglossal duct cyst. J Robot Surg, 2018. 12(2): p. 357-360.
25. Lee, D.K., et al., Efficacy of Ethanol Ablation for Thyroglossal Duct Cyst. 2015. 124(1): p. 62-67.
26. Kim, M.G., et al., The therapeutic effect of OK-432 (picibanil) sclerotherapy for benign neck cysts. Laryngoscope, 2008. 118(12): p. 2177-81.
27. Talmor, G., et al., Sclerotherapy for Benign Cystic Lesions of the Head and Neck: Systematic Review of 474 Cases. Otolaryngol Head Neck Surg, 2021. 165(6): p. 775-783.
28. Maddalozzo, J., T.K. Venkatesan, and P. Gupta, Complications Associated With the Sistrunk Procedure. 2001. 111(1): p. 119-123.
29. Burgués Prades, P.L., et al., [Thyroglossal duct cysts. Do prior inflammatory episodes influence the number of recurrences?]. Anales espanoles de pediatria, 1996. 44(5): p. 422-424.
30. Ducic, Y., et al., Recurrent thyroglossal duct cysts: a clinical and pathologic analysis. International Journal of Pediatric Otorhinolaryngology, 1998. 44(1): p. 47-50.
31. Ostlie, D.J., et al., Thyroglossal duct infections and surgical outcomes. Journal of Pediatric Surgery, 2004. 39(3): p. 396-399.
32. Marianowski, R., et al., Risk factors for thyroglossal duct remnants after Sistrunk procedure in a pediatric population. International Journal of Pediatric Otorhinolaryngology, 2003. 67(1): p. 19-23.
33. Kaselas, C., et al., Thyroglossal duct cyst’s inflammation. When do we operate? Pediatr Surg Int, 2005. 21(12): p. 991-3.
1. Oral and Maxillofacial Surgery Clinic, G.Papanikolaou General Hospital in Thessaloniki(Director Professor Konstantinos Vaxtsevanos).
2. Pathology Department, G. Papanikolaou General Hospital in Thessaloniki.
3. Dental School, Aristotle University of Thessaloniki.
DOI:DOI:https://dx.doi.org/10.54936/haoms2411524
SUMMARY: Thyroglossal duct cyst is the most common swelling of fetal origin in the cervix, located predominantly in the frontal neck area. The prevalence of the disease is 7%, while in bibliography there is some controversy regarding the age of diagnosis, since some authors find greater occurrence in children and others in adults.[1-3] Clinically, it usually appears as a mobile, painless mass without tension most commonly located below the hyoid bone (75% of the patients), but if inflammated, it can be accompanied by pain. The indicated therapeutic approach of thyroglossal duct cysts is surgical removal under general anesthesia according to Sistrunk technique, that ensures the full removal of the cyst’s wall including part of the hyoid bone body with which it is usually attached. The aim of the present study which was written based on SCARE 2020 protocol according to EQUATOR[4]is the presentation of a series of 5 cases which were surgically treated in the University Clinic of Oral and Maxillofacial Surgery of G.Papanikolaou General Hos-pital in a 2.5 years time frame(9/2019-2/2022). Four of the patients were men(80%) (mean age 50.5 years, ranging from 36 to 71 years old) and one was a 63 year old woman(20%). All of the patients presented in the outpatient unit of the clinic with a painless mobile neck mass, that appeared euthyroid from the laboratory tests. All of the patients underwent surgical removal of the thyroglossal duct cyst and part of the hyoid bone at the same time (Sistrunk procedure). No regression was
noticed in the frequent postoperative follow-up. In conclusion, thyroglossal duct cyst is a clinically evident entity which although is more often diagnosed
and treated surgically in childhood, it can also appear in adults. It may be complicated with inflammation and appear as a painful neck swelling. The treatment of choice is surgical removal according to Sistrunk procedure.
KEY WORDS: Thyroglossal cyst, adult patients, surgical removal, case series
REFERENCES:
1. Lin, S.-T., et al., Thyroglossal duct cyst: a comparison between children and adults. American Journal of Otolaryngology, 2008. 29(2): p. 83-87.
2. Brousseau, V.J., et al., Thyroglossal duct cysts: presentation and management in children versus adults. Int J Pediatr Otorhinolaryngol, 2003. 67(12): p. 1285-90.
3. Allard, R.H., The thyroglossal cyst. Head Neck Surg, 1982. 5(2): p. 134-46.
4. Agha, R.A., et al., The SCARE 2020 Guideline: Updating Consensus Surgical CAse REport (SCARE) Guidelines. International Journal of Surgery, 2020. 84: p. 226-230.
5. Amos, J. and C. Shermetaro, Thyroglossal Duct Cyst, in StatPearls. 2022, StatPearls Publishing Copyright © 2022, StatPearls Publishing LLC.: Treasure Island (FL).
6. Brewis, C., et al., Investigation and treatment of thyroglossal cysts in children. 2000. 93(1): p. 18-21.
7. Sistrunk, W.E., THE SURGICAL TREATMENT OF CYSTS OF THE THYROGLOSSAL TRACT. Ann Surg, 1920. 71(2): p. 121-122.2. 8. Rohof, D., et al., Recurrences after thyroglossal duct cyst surgery: Results in 207 consecutive cases and review of the literature. Head Neck, 2015. 37(12): p. 1699-704. 9. de Tristan, J., et al., Thyroglossal duct cysts: 20 years’ experience (1992-2011). Eur Arch Otorhinolaryngol, 2015. 272(9): p. 2513-9. 10. Pelausa, M.E. and V. Forte, Sistrunk revisited: a 10-year review of revision thyroglossal duct surgery at Toronto’s Hospital for Sick Children. J Otolaryngol, 1989. 18(7): p. 325-33.
11. Ahmed, J., et al., The extended Sistrunk procedure for the management of thyroglossal duct cysts in children: how we do it. 2011. 36(3): p. 271-275.
12. Perkins, J.A., et al., Recurrent Thyroglossal Duct Cysts: A 23- Year Experience and a New Method for Management. 2006. 115(11): p. 850-856.
13. O’Neil, L.M., et al., Wide anterior neck dissection for management of recurrent thyroglossal duct cysts in adults. J Laryngol Otol, 2016. 130 Suppl 4: p. S41-4.
14. El-Anwar, M.W. and A.A. Nofal, Thyroglossal duct cyst excision with hyoid bone preservation. Eur Arch Otorhinolaryngol, 2016. 273(6): p. 1521-6.
15. Ryu, Y.-J., et al., Modified Sistrunk operation: New concept for management of thyroglossal duct cyst. International Journal of Pediatric Otorhinolaryngology, 2015. 79(6): p. 812-816.
16. Koempel, J.A., Thyroglossal duct remnant surgery: A reliable, reproducible approach to the suprahyoid region. International Journal of Pediatric Otorhinolaryngology, 2014. 78(11): p. 1877-1882.
17. Patel, N.N., B.E.J. Hartley, and D.J. Howard, Management of thyroglossal tract disease after failed Sistrunk’s procedure. Journal of Laryngology and Otology, 2003. 117(9): p. 710-712
18. Michael K, K.I.M., P. Bruce R, and I. Glenn, Central neck dissection for the treatment of recurrent thyroglossal duct cysts in childhood. Otolaryngology - Head and Neck Surgery, 1999. 121(5): p. 543-547.
19. Kim, J.P., J.J. Park, and S.H. Woo, No-Scar Transoral Thyroglossal Duct Cyst Excision in Children. Thyroid, 2018. 28(6): p. 755-761.
20. Kim, C.-H., et al., Robot-assisted Sistrunk operation via a retroauricular approach for thyroglossal duct cyst. 2014. 36(3): p. 456-458.
21. Kayhan, F.T., et al., Transoral surgery for an infant thyroglossal duct cyst. International Journal of Pediatric Otorhinolaryngology, 2013. 77(9): p. 1620-1623. 22. Byeon, H.K., et al., Robot-Assisted Sistrunk’s Operation, Total Thyroidectomy, and Neck Dissection via a Transaxillary and Retroauricular (TARA) Approach in Papillary Carcinoma Arising in Thyroglossal Duct Cyst and Thyroid Gland. Annals of Surgical Oncology, 2012. 19(13): p. 4259-4261.
23. Burkart, C.M., et al., Update on endoscopic management of lingual thyroglossal duct cysts. 2009. 119(10): p. 2055-2060.
24. Fong, S., et al., Transoral robotic excision of a lingual thyroglossal duct cyst. J Robot Surg, 2018. 12(2): p. 357-360.
25. Lee, D.K., et al., Efficacy of Ethanol Ablation for Thyroglossal Duct Cyst. 2015. 124(1): p. 62-67.
26. Kim, M.G., et al., The therapeutic effect of OK-432 (picibanil) sclerotherapy for benign neck cysts. Laryngoscope, 2008. 118(12): p. 2177-81.
27. Talmor, G., et al., Sclerotherapy for Benign Cystic Lesions of the Head and Neck: Systematic Review of 474 Cases. Otolaryngol Head Neck Surg, 2021. 165(6): p. 775-783.
28. Maddalozzo, J., T.K. Venkatesan, and P. Gupta, Complications Associated With the Sistrunk Procedure. 2001. 111(1): p. 119-123.
29. Burgués Prades, P.L., et al., [Thyroglossal duct cysts. Do prior inflammatory episodes influence the number of recurrences?]. Anales espanoles de pediatria, 1996. 44(5): p. 422-424.
30. Ducic, Y., et al., Recurrent thyroglossal duct cysts: a clinical and pathologic analysis. International Journal of Pediatric Otorhinolaryngology, 1998. 44(1): p. 47-50.
31. Ostlie, D.J., et al., Thyroglossal duct infections and surgical outcomes. Journal of Pediatric Surgery, 2004. 39(3): p. 396-399.
32. Marianowski, R., et al., Risk factors for thyroglossal duct remnants after Sistrunk procedure in a pediatric population. International Journal of Pediatric Otorhinolaryngology, 2003. 67(1): p. 19-23.
33. Kaselas, C., et al., Thyroglossal duct cyst’s inflammation. When do we operate? Pediatr Surg Int, 2005. 21(12): p. 991-3.
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