Thyroglossal duct cyst’s inflammation. When do we operate?

Abstract

Thyroglossal duct cyst (TGDC) disease, one of the most common developmental neck lesion in the pediatric population, often presents as infected neck mass. The authors reviewed their experience in the management of inflamed TGDC cases, in order to suggest the most efficient approach of these patients regarding the ideal type and time of surgical intervention. The medical records of all the patients with the diagnosis of TGDC treated at our department from 1988 to 2003 were reviewed. Data collected included age, gender, preoperative inflammation, treatment and time of definitive surgery. The outcome of the operation was graded as successful, recurrence, or postoperative infection. Eighty-nine (89) patients with histologically confirmed TGDC were treated at our department. Mean age at operation was 6.0 years (range, 9 months-14 years). Male to female ratio was 1.2:1. All patients underwent Sistrunk operation and the mean follow-up was 3 years. Fifty-four (54) patients (60.6%) presented with an inflamed TGDC. Among them, 24 patients were operated immediately after diagnosis at the phase of acute inflammation, and 30 patients after antibiotic administration and resolution of inflammation. The overall recurrence incidence was 6.7%. Recurrence was noted in 6 of 24 (25%) patients operated during the acute phase of inflammation and none in patients operated after resolution of inflammation (P = 0.0052) or with no preoperative inflammation (P = 0.0002). Postoperative wound infection was noted in seven cases but none of them developed recurrence of the disease. The presence of inflammation at the time of surgery is an important risk factor for relapse. We suggest that in the inflamed cases of TGDC disease, the initial treatment should be antibiotic administration and after resolution of the inflammation, surgical management should follow.

Recurrences after thyroglossal duct cyst surgery: Results in 207 consecutive cases and review of the literature

“…In Table , the available literature on the results of resection for thyroglossal duct cyst is summarized. Only studies published in English from 1998 to 2012, reporting on at least 10 patients who underwent resection for thyroglossal duct cyst are included.…”

Ultrasound-guided sclerotherapy for benign non-thyroid cystic mass in the neck

“…The presence of inflammation at the time of surgery is an important risk factor for relapse, and the initial treatment should be the administration of antibiotics in the sclerotherapy as well as in the surgery [29]. As a possible alternative, Kim et al [1] have reported complete regression of a thyroglossal duct cyst after sclerotherapy with 1 KE OK-432 in 10 mL of normal saline at a volume equivalent to the cyst aspirate in 5 of 11 patients, and although its use is still rare, there have been a few reports of successful ethanol sclerotherapy for these cysts.…”

Experiencia en el manejo de la patología del conducto tirogloso: serie de casos

“…La edad de presentación de la PCT presenta una curva bimodal, con un pico a los 5-6 años 9 inician el tratamiento médico y posponen 3 meses la cirugía. En ambos casos, la antibioticoterapia se continúa hasta 7 días después de la operación.…”