Impact of Incision and Drainage of Infected Thyroglossal Duct Cyst on Recurrence After Sistrunk Procedure | Endocrine Surgery | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
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1.
Chandra RK, Maddalozzo J, Kovarik P. Histological characterization of the thyroglossal tract: implications for surgical management.  Laryngoscope. 2001;111(6):1002-100511404612PubMedGoogle ScholarCrossref
2.
Ellis PD, van Nostrand AW. The applied anatomy of thyroglossal tract remnants.  Laryngoscope. 1977;87(5, pt 1):765-770850454PubMedGoogle ScholarCrossref
3.
Brousseau VJ, Solares CA, Xu M, Krakovitz P, Koltai PJ. Thyroglossal duct cysts: presentation and management in children versus adults.  Int J Pediatr Otorhinolaryngol. 2003;67(12):1285-129014643470PubMedGoogle ScholarCrossref
4.
Dedivitis RA, Camargo DL, Peixoto GL, Weissman L, Guimarães AV. Thyroglossal duct: a review of 55 cases.  J Am Coll Surg. 2002;194(3):274-27711893130PubMedGoogle ScholarCrossref
5.
Josephson GD, Spencer WR, Josephson JS. Thyroglossal duct cyst: the New York Eye and Ear Infirmary experience and a literature review.  Ear Nose Throat J. 1998;77(8):642-644, 646-647, 6519745181PubMedGoogle Scholar
6.
Sturgis EM, Miller RH. Thyroglossal duct cysts.  J La State Med Soc. 1993;145(11):459-4618270841PubMedGoogle Scholar
7.
Waddell A, Saleh H, Robertson N, Khalil HS, Bridger MWM. Thyroglossal duct remnants.  J Laryngol Otol. 2000;114(2):128-12910748829PubMedGoogle ScholarCrossref
8.
Hanna E. Squamous cell carcinoma in a thyroglossal duct cyst (TGDC): clinical presentation, diagnosis, and management.  Am J Otolaryngol. 1996;17(5):353-3578870944PubMedGoogle ScholarCrossref
9.
Pribitkin EA, Friedman O. Papillary carcinoma in a thyroglossal duct remnant.  Arch Otolaryngol Head Neck Surg. 2002;128(4):461-46411926928PubMedGoogle Scholar
10.
Shepard GH, Rosenfeld L. Carcinoma of thyroglossal duct remnants: review of the literature and addition of two cases.  Am J Surg. 1968;116(1):125-1295652346PubMedGoogle ScholarCrossref
11.
Sistrunk WE. The surgical treatment of cysts of the thyroglossal tract.  Ann Surg. 1920;71(2):121.2-122.217864229PubMedGoogle ScholarCrossref
12.
Sistrunk WE. Technique of removal of cysts and sinuses of the thyroglossal duct.  Surg Gynecol Obstet. 1928;46:109-112Google Scholar
13.
Türkyilmaz Z, Sönmez K, Karabulut R,  et al.  Management of thyroglossal duct cysts in children.  Pediatr Int. 2004;46(1):77-8015043670PubMedGoogle ScholarCrossref
14.
Ein SH, Shandling B, Stephens CA, Mancer K. The problem of recurrent thyroglossal duct remnants.  J Pediatr Surg. 1984;19(4):437-4396481589PubMedGoogle ScholarCrossref
15.
Marianowski R, Ait Amer JL, Morisseau-Durand MP, Manach Y, Rassi S. Risk factors for thyroglossal duct remnants after Sistrunk procedure in a pediatric population.  Int J Pediatr Otorhinolaryngol. 2003;67(1):19-2312560145PubMedGoogle ScholarCrossref
16.
Mickel RA, Calcaterra TC. Management of recurrent thyroglossal duct cysts.  Arch Otolaryngol. 1983;109(1):34-366848104PubMedGoogle ScholarCrossref
17.
Ostlie DJ, Burjonrappa SC, Snyder CL,  et al.  Thyroglossal duct infections and surgical outcomes.  J Pediatr Surg. 2004;39(3):396-39915017559PubMedGoogle ScholarCrossref
18.
Hirshoren N, Neuman T, Udassin R, Elidan J, Weinberger JM. The imperative of the Sistrunk operation: review of 160 thyroglossal tract remnant operations.  Otolaryngol Head Neck Surg. 2009;140(3):338-34219248939PubMedGoogle ScholarCrossref
19.
Bennett KG, Organ CH Jr, Williams GR. Is the treatment for thyroglossal duct cysts too extensive?  Am J Surg. 1986;152(6):602-6053789282PubMedGoogle ScholarCrossref
20.
Athow AC, Fagg NL, Drake DP. Management of thyroglossal cysts in children.  Br J Surg. 1989;76(8):811-8142765833PubMedGoogle ScholarCrossref
21.
Shah R, Gow K, Sobol SE. Outcome of thyroglossal duct cyst excision is independent of presenting age or symptomatology.  Int J Pediatr Otorhinolaryngol. 2007;71(11):1731-173517765325PubMedGoogle ScholarCrossref
22.
Perkins JA, Inglis AF, Sie KC, Manning SC. Recurrent thyroglossal duct cysts: a 23-year experience and a new method for management.  Ann Otol Rhinol Laryngol. 2006;115(11):850-85617165669PubMedGoogle Scholar
23.
Ducic Y, Chou S, Drkulec J, Ouellette H, Lamothe A. Recurrent thyroglossal duct cysts: a clinical and pathologic analysis.  Int J Pediatr Otorhinolaryngol. 1998;44(1):47-509720680PubMedGoogle ScholarCrossref
24.
Hoffman MA, Schuster SR. Thyroglossal duct remnants in infants and children: reevaluation of histopathology and methods for resection.  Ann Otol Rhinol Laryngol. 1988;97(5, pt 1):483-4863178099PubMedGoogle Scholar
25.
Pelausa ME, Forte V. Sistrunk revisited: a 10-year review of revision thyroglossal duct surgery at Toronto's Hospital for Sick Children.  J Otolaryngol. 1989;18(7):325-3332593216PubMedGoogle Scholar
26.
 Current Procedural Terminology. Chicago, IL: American Medical Association; 2011
Original Article
Jan 2012

Impact of Incision and Drainage of Infected Thyroglossal Duct Cyst on Recurrence After Sistrunk Procedure

Author Affiliations

Author Affiliations: Departments of Otolaryngology, Louisiana State University Health Sciences Center and Children's Hospital of New Orleans, New Orleans, Louisiana (Dr Simon); and Department of Otolaryngology, Rady Children's Hospital and Division of Otolaryngology, University of California, San Diego, San Diego, California (Dr Magit).

Arch Otolaryngol Head Neck Surg. 2012;138(1):20-24. doi:10.1001/archoto.2011.225
Abstract

Objective To determine whether incision and drainage of infected thyroglossal duct cysts (TGDCs) is associated with increased risk of recurrence after Sistrunk procedure when compared with antibiotic treatment alone.

Design Retrospective case review.

Setting Tertiary referral practice.

Patients Patients treated for thyroglossal duct remnants in a tertiary care pediatric center from January 1, 2002, through December 31, 2008. Study subjects were identified using the diagnosis code for TGDC or the procedure code for excision of thyroglossal duct cyst or sinus.

Main Outcome Measures The presence of infection, treatment of infected TGDCs, and relationship between infection, treatment of infection, and recurrence.

Results We identified 120 patients from 2002 through 2008 who met the search criteria. The mean age at the time of presentation was 5.1 years; at the time of surgery, 5.4 years. More than half the patients (58.2%) were male, and the most common presentation was an asymptomatic midline neck mass. Forty-nine of our patients (40.8%) had a history of infection and 6 of these (12%) required incision and drainage. The overall recurrence rate was 10.8%. Ten of the patients with preoperative infection (20%) had a recurrence compared with 3 of the 71 patients (4%) without preoperative infection (P = .002). Of all patients with recurrences, only 1 had undergone incision and drainage.

Conclusions This case series suggests that preoperative infection is associated with an increased recurrence rate. Incision and drainage of an infected TGDC may not increase the risk of postoperative recurrence. The results of this case series may assist in preoperative counseling and management of infected TGDC prior to definitive surgery.

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