Pediatric thyroglossal duct cysts: Post-operative complications

Lekkerkerker, Iris; Heurn, Ernest L. W. van; Steeg, Alida F. W. van der; Derikx, Joep P. M.

doi:10.1016/j.ijporl.2019.05.035

Cited by 10 publications

(10 citation statements)

References 14 publications

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“…[19][20][21][22][23][24][25] The most common complications were seroma and SSIs, which is consistent with the literature. 16,21,23,[26][27][28][29] Most importantly, we found that the history of infection significantly predicted wound complications.…”

Section: Postoperative Complicationsmentioning

confidence: 63%

Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedure

Wynings,

Wang,

Parsa

et al. 2023

Laryngoscope Investig Oto

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ObjectivesThyroglossal duct cyst (TGDC) is the most common pediatric congenital neck mass. The Sistrunk procedure is the standard method of excision and is associated with low rates of recurrence. This study aimed to review our institution's outcomes following the Sistrunk procedure, specifically the rates of wound complications and cyst recurrence.MethodsThis was a retrospective case series of pediatric patients undergoing the Sistrunk procedure from June 2009 to April 2021.ResultsA total of 273 patients were included. Of these, 139 (53%) patients were male and 181 (66%) were white. The average age at the time of surgery was 7.1 years. The overall cyst recurrence rate was 11%. The most common wound complications were seroma (14%) and surgical site infections (SSIs) (12%). Wound complications were associated with prior history of cyst infection (odds ratio [OR] 1.97, 95% confidence interval [CI] 1.07–3.60, z‐test 2.2, p = .03). Pediatric surgery was associated with fewer wound complications (OR 0.18; 95% CI 0.05–0.6, z‐test −2.78, p = .005). However, pediatric surgery operated on fewer patients with a history of cyst infection (36% vs. 55%, p = .012). Drain placement and postoperative antibiotics did not affect rates of wound complications.ConclusionsPrior cyst infection is associated with increased rates of postoperative wound complications. Postoperative antibiotics and drain placement did not significantly affect complication rates.Level of Evidence4.

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Section: Postoperative Complicationsmentioning

confidence: 63%

Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedure

Wynings,

Wang,

Parsa

et al. 2023

Laryngoscope Investig Oto

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show abstract

“…In early studies, younger patients had a higher recurrence rate after surgery (12). However, more and more studies have verified that the recurrence rate was similar in any age group (13,24). The high recurrence rate in early studies may be due to noncompliance with the Sistrunk procedure.…”

Section: Discussionmentioning

confidence: 99%

“…It was reported that the recurrence rates were 1/2 and 1/3 when the children were operated on under the ages of 1 year and 2 years old, respectively ( 12 ). However, recent studies suggested that age may not be a risk factor for adverse outcomes ( 6 , 13 ). Another factor raising concerns about the early operation is anesthesia-induced neurotoxicity in the developing brain.…”

Section: Introductionmentioning

confidence: 99%

Optimal age of surgery for children with thyroglossal duct cysts: A single-institution retrospective study of 340 patients

Wang

Yang

2023

Front. Pediatr.

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ObjectiveThe recommended age of surgery for thyroglossal duct cysts (TGDCs) in children is inconclusive. This study aimed to explore the optimal age of surgery by analyzing the natural history of the disease and the association between the age of surgery and postoperative complications.MethodsAll TGDC patients who underwent a modified Sistrunk procedure at our hospital between March 2010 and May 2022 were reviewed retrospectively. The evaluation focused on the age of preoperative symptomatic cystic infection, pathological inflammation, postoperative wound infection, and recurrence.ResultsOf the 340 patients included in the study, the median age of surgery was 47.5 months (IQR, 24.1–61.6). Preoperative symptomatic cystic infection and pathological inflammation frequencies were 27.1% (n = 92) and 48.5% (n = 165), respectively. The cumulative hazard of symptomatic cystic infection and pathological inflammation increased steadily with age. The ages of 50% cumulative incidence of symptomatic cystic infection and pathological inflammation were 97 months and 71 months, respectively. Postoperative wound infection was higher in patients of younger age (OR = 0.96, 95% CI, 0.93–0.98, P < 0.001) and with symptomatic cystic infection (OR = 8.16, 95% CI, 2.54–36.86, P = 0.002). There was no significant association between the age of surgery and recurrence.ConclusionAlthough wound infection was weakly associated with younger age, the symptomatic cystic infection increasing with age has a more remarkable impact on wound infection after the Sistrunk procedure. The recurrence rate did not increase in young patients receiving surgery. Therefore, the Sistrunk procedure was safe and effective at a young age, and prompt operation in children with TGDC once diagnosed was reasonable.

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“…Su diagnóstico es principalmente clínico, sin embargo, la ecografía de cuello es el estudio inicial que permite a localizar el quiste y sobre todo permite localizar la glándula tiroides, lo cual es necesario para evitar iatrogenia durante el manejo operatorio (13,14). El manejo es quirúrgico (11), con una recurrencia descrita del tratamiento entre el 0 % al 8 % ( 15). En el abordaje inicial debe realizarse pruebas de función tiroidea para excluir hipotiroidismo o si se sospecha la presencia de tejido ectópico de la glándula tiroides, la gammagrafía tiroidea es la ayuda diagnostica de elección para identificar el tejido funcional ectópico tiroideo (16).…”

Section: Introductionunclassified

“…Las complicaciones quirúrgicas descritas son, infección local, hematomas, obstrucción de la vía aérea, fiebre, hemorragia, resección accidental de la tráquea y recurrencia por resecciones incompletas, siendo de estas complicaciones, las más frecuentes la infección y la recurrencia (17,18). Otra complicación es la presencia de hipotiroidismo postoperatorio, luego de extraer tejido tiroideo ectópico de la glándula tiroides, asociado con el quiste del conducto tirogloso (16).…”

Section: Introductionunclassified

Caracterización de quiste tirogloso en pacientes pediátricos

Cuastumal

Zapata

2021

Pediatria.

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Introducción: el quiste del conducto tirogloso es una anomalía congénita frecuente en la línea media del cuello, generalmente se manifiesta durante la primera década de la vida, pero puede manifestarse a cualquier edad. Clásicamente se presenta como una masa en la línea media anterior que se mueve con la deglución y la protrusión de la lengua; en ocasiones se presenta de manera atípica lo que puede dificultar el diagnostico. Tiene una tasa de recurrencia del 4% al 50 % aun después de la cirugía electiva de Sistrunk. Objetivo: caracterizar la forma de presentación clínica y el tratamiento de los pacientes pediátricos con diagnostico de quiste tirogloso en una institución pediátrica. Métodos: estudio descriptivo retrospectivo durante el periodo del 2010 - 2020 Resultados: se identificaron 59 pacientes con quiste tirogloso, de los cuales el promedio de edad fue de 5.8 años, el 50.9 % eran del sexo masculino, la localización más frecuente hallada fue en la región medial del cuello 86.4 %, los pacientes principalmente presentaron sensación de masa indolora en esta región en el 74.5 %, secreción 18.6 %, sensibilidad y enrojecimiento 5.1 %, disfagia 1.7 %. La expresión clínica más frecuente de la masa en cuello fue la presencia de quiste tirogloso en el 74.8 % de los casos y el debut con fistula en el 11.6 %. Conclusión: la ecografía de cuello evidencio en un 100 % de los casos el quiste tirogloso y logro ubicar la presencia de glándula tiroides en su sitio habitual en el 88 %, al 20.3 % de los pacientes se les tomo pruebas tiroideas y gammagrafía al 12 % de ellos; se detectó recurrencia en 9 pacientes.

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Pediatric thyroglossal duct cysts: Post-operative complications

Cited by 10 publications

References 14 publications

Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedure

Risk‐adjusted analysis of perioperative outcomes after the Sistrunk procedure

Optimal age of surgery for children with thyroglossal duct cysts: A single-institution retrospective study of 340 patients

Caracterización de quiste tirogloso en pacientes pediátricos

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