Management of thyroglossal cyst in adults: A single-institution experience

Abstract

Objectives: Thyroglossal duct cyst (TDC) is the most common congenital anterior neck mass in clinical practice. Due to its congenital origin, presentation in adulthood is uncommon with only 7% of cases presenting in this age group. Data are therefore limited on the management of TDC in adults, particularly in Sub-Saharan Africa. This study describes the pattern of the presentation and treatment outcomes, following the management of TDC in a series of adults in a Nigerian tertiary hospital. Subjects and Methods: A retrospective review of all adult patients with TDCs over a 5-year period was carried out. Sociodemographic data, operative details, and postoperative outcomes were obtained and presented as descriptive statistics. Results: Seven adult patients, including five males and two females, were managed during the period. Their ages ranged from 19 to 60 years, with a mean of 37 ± 16.4 years. All the patients presented with anterior neck swellings which had been present for a median duration of 3 years. Cysts were located in the infrahyoid position in all instances, and all had Sistrunk operation over a mean operative time of 78 ± 16 min. There were no intraoperative complications. The mean duration of the postoperative stay was 2 days. There was no recurrence after a median follow-up period of 15 months. Conclusion: This study highlights the rarity of TDC in adults and describes a single institution's experience with the management of adult cases of TDC using the classical Sistrunk operation.

Management Outcome of Adult Thyroglossal Duct Cyst in a General Surgery Tertiary Practice in Sub-Saharan Africa, Nigeria

“…The age range of 15-74 years is consistent with that of most reviews from Africa [7]. While the sex distribution (three males and two females) in this report is consistent with the ratio of 1:1 in other publications in the literature [8], the actual gender distribution may be unknown due to the limited number of cases and the variation in gender distribution [7].…”

“…This justifies preoperative routine thyroid ultrasound and thyroid function tests. All the patients in this study had Sistrunk operation which is the documented standard technique for TDC [ 7 ]. While other surgical methods exist; they are all associated with high recurrence rate with simple cystectomy reported as high as 100% [ 6 ].…”

“…Other rare complications include damage to the hypoglossal nerve due to its proximity to the hyoid bone. The nerve is avoided with careful dissection and sparing of the superior horn of the hyoid bone [ 6 , 7 ]. Post-operative infections were not recorded in any of the patients although its incidence has been reported to be as high as 40% [ 6 ].…”

Thyroglossal Duct Cyst Infection Caused by Neisseria gonorrhoeae: An Unusual Complication of Pharyngeal Gonorrhea

“…After radiologic confirmation by either high-resolution ultrasound or CT scans of the neck, 2,3 the definitive surgical management is via the surgical Sistrunk procedure 2,6–8 that involves removal of the cyst, central portion of the hyoid bone, and the tract up to the foramen cecum. Resolution of a superimposed infection of the cyst is paramount, as such an occurrence increases the risk of postoperative relapse 9,10 …”