Abstract
Thyroglossal duct remnants are the most common midline neck masses in childhood, representing more than 75% of such masses. Surgical treatment with the Sistrunk operation (wide excision of the cyst, duct, central hyoid, and a core of tongue base) remains the standard of care, with a low recurrence rate and minimal morbidity. Controversy exists over the appropriate preoperative evaluation of children with presumed TGD remnants since postoperative hypothyroidism can occur from inadvertent removal of the only functioning ectopic thyroid tissue. The options for evaluation include the following: • No preoperative studies • No preoperative studies; look for thyroid gland during surgery • Radioisotope scanning of the thyroid gland for all patients before surgery • Other imaging modalities, such as ultrasonography, computed tomography, or magnetic resonance imaging • Radioisotope scanning of the thyroid gland in selected patients before surgery based on a history suggestive of hypothyroidism, thyroid function tests, an inability to palpate thyroid gland, or other radiographic tests The following sections will discuss the relative merits of preoperative scanning of the thyroid gland in patients with suspected TGD remnants.
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