Presentations and management of thyroglossal duct cyst in children versus adults: a review of 106 cases

Abstract

The objective of this study was to determine the clinical presentations and management of thyroglossal duct cyst (TDC or thyroglossal tract remnant [TTR]) between children and adults and evaluate risk factors associated with recurrence after surgery for TDCs. A retrospective study of all patients with TDCs managed in our department from January 1998 through April 2008 was performed. All records were reviewed for age and sex, sizes and locations of cysts, diagnostic methods, surgical management, recurrences, and complications. Differences between children and adults and risk factors associated with recurrence were evaluated. A total of 106 patients (47 children and 59 adults) were treated for TDC. Of the children, 57.4% were male and 42.6% were female, whereas 50.8% of the adults were male and 49.2% were female. There were no significant differences in sex in either group (P > .49). The average age was 7.0 ± 4.2 years in children and 36.0 ± 18.0 years in adults, which demonstrates a bimodal distribution. Adults were significantly more likely than children to present with a complaint other than mass or infection (P < .01), including pain, dysphagia, dysphonia, and fistula formation. There was no significant difference in frequency of location between the adults and children. In this article, 94.9% (56/59) of the adults and 87.2% (41/47) of the children underwent a Sistrunk operation, whereas the others underwent cyst excision. There were 2 recurrences among adults and 3 among children, all of whom presented with an infected neck mass and were treated with a second Sistrunk procedure. The recurrence rates and complications between children and adults were not significantly different. The incidence of TDC was equal in males and females and had a bimodal distribution with similar incidence in children and adults. Adults were significantly more likely than children to present with a complaint other than mass or infection. The Sistrunk procedure is recommended as the main choice of treatment. Cyst infection may have a role in recurrence.