A Clinical Analysis of Thyroglossal Duct Cyst and Sinus

ABSTRACT

PURPOSE: Anomalies in the thyroglossal duct are the most common midline, or paramedian cervical lesions of congenital origin. Presenting as a thyroglossal duct cyst (TGDC) or a thyroglossal duct sinus (TGDS), they are found in all age groups. This clinical study was intended to elucidate the clinical characteristics, and the outcomes, of surgical treatment of these anomalies. METHODS: Between January 1992 and May 2002, 91 patients underwent surgery for a TGDC or a TGDS at 4 hospitals affiliated to Hallym University. The demographics of the patients, the clinical characteristics of the lesions, and the outcomes of the treatments were retrospectively evaluated. These characteristics were evaluated according to age groups; younger than 15 (38 patients) and older than 15 (53 patients) years. RESULTS: The male to female ratio was 1.67 1 (It is better to give the actual figures.), with the first decade showing the highest incidence in the age distribution (33%). Painless masses (83.6%) were the most common presenting symptom, with most symptoms having been manifest for less than 1 year (67%). TGDCs were 90% and TGDSs were 10%. There were 62 cases of infrahyoid and 18 of suprahyoid lesions, with 80 cases on the midline and 11 on the paramedian within 2 cm from the midline. Of the paramedian lesions, 2 cases were in the younger group and 9 were in the older group. This tendency of laterality in the location by age group showed no statistical significance (p=0.172). All the patients underwent a Sistrunk operation, and one experienced a recurrence. CONCLUSION: This study justified the Sistrunk operation as the treatment of choice for anomalies of the thyroglossal duct. The lateral lesions occurred in the old age groups more frequently. A careful approach is needed with paramedian cervial lesions in adults to avoid the loss of the proper treatment of possible hidden congenital lesions.