Thyroglossal Duct Cyst & Sistrunk, a Case Series; Personal Experience and Literature Review

Abstract

Objectives: The purpose of this article is to describe a modified surgical approach to the Thyroglossal duct cyst (TGDC) where the incision is given at upper pole of cyst which offers easy cephalic dissection which is at times difficult and required multiple incisions like sistrunk operation. Further it gives better cosmetic results with no recurrence. Study Design: A total of 48 Patients with the diagnosis of TGDC were assigned from sep 2012 to oct 2014 to have either sistrunk (n=20) or sistrunk with modified incision (n=28) after clinical and radiological assessment in the department of otolaryngology, Pt. B.D Sharma PGIMS Rohtak, Haryana. Ease of resection, recurrence rate and cosmetic outcome were noted. Results: There was no significant difference in the rate of complications and operative time of the procedure between the two procedures. There was statistically significant difference in recurrence rate in sistrunk procedure (3/20 ) as compared to sistrunk procedure with modified incision(0/28) (P = 0.04). All of whom presented with an infected neck mass and were treated with a second Sistrunk procedure. Conclusion: Modified incision gave good results in our series with decrease operative time of the procedure, allow the surgeon to achieve and maintain an excellent exposure at the level of hyoid as well as foramen ceacum making it easy for complete excision and decrease recurrence rate. Further it has better cosmetic outcome as high scar is not visible as it merges within langers lines.