Thyroglossal duct surgery. Sistrunk procedure

Abstract

Midline cysts of the neck are the most common congenital malformations of the neck. They arise along the thyroglossal duct. The presence of a fistula is the result of either spontaneous (suppuration) or surgical fistulisation (simple incision or incomplete excision). The cyst and/or fistula are located between the base of the tongue and the thyroid gland, predominantly adjacent to the hyoid bone. This midline site can be explained by embryological development of the thyroid gland. Treatment is surgical. Many techniques have been described, but Sistrunck procedure (described in 1920), based on embryological studies, remains the reference technique with a recurrence rate of less than 3%, provided surgery is performed correctly, comprising resection of the body of the hyoid. Risk factors for recurrence are: surgery during the inflammatory phase, cyst rupture during dissection, multiple thyroglossal ducts and a technical error during the surgical procedure.

Ultrasonographic features differentiating thyroglossal duct cysts from dermoid cysts

“…However, even though TGDCs and DCs are clinically similar, only TGDCs require the Sistrunk procedure, which involves the removal of the entire tract, along with the middle third of the hyoid bone. This is because TGDCs tend to recur if only simple excision is performed [ 1 , 8 , 9 ]. Conversely, the standard treatment for DCs is simple excision of the cyst [ 10 ].…”

Occult papillary thyroid carcinoma with cystic nodal metastasis mimicking a thyroglossal duct cyst: A case report

“…Thyroglossal duct cysts are typically lined with either respiratory (columnar to stratified cuboidal) epithelium (38 %), squamous epithelium (10 %), or a combination of both types (51 %). A sistrunk procedure is the preferred surgical approach for uncomplicated TDC due to its lower risk of recurrence [13]. If a malignancy is identified then staging investigations are indicated to exclude metastatic disease.…”

Case of a Large Oropharyngeal Cyst

“…The thyroid originates at the base of the tongue and migrates caudally to its permanent position in the inferior neck anterior to the trachea by the seventh week of gestation. The duct connecting the thyroid to the tongue typically atrophies by the tenth week of gestation; however, failure of this process can give rise to midline cysts that can be diagnosed at any age [2]. These cysts move with swallowing and are histologically characterized by respiratory epithelium, squamous epithelium, or a combination of the two.…”