Diagnosis Of Thyroglossal Duct Cyst Research Articles

Morbimortality and malignancy in patients treated with the Sistrunk procedure technique for the treatment of thyroglossal duct cyst in UMAE hospital de Especialidades Dr. Antonio Fraga Mouret Centro Médico Nacional La Raza

Background: Describes the morbidity and malignancy in patients treated with the Sistrunk procedure technique for the treatment of thyroglossal cyst from 2017 to 202 in UMAE specialty hospital "Dr Antonio Fraga Mouret” CMN La Raza. Methods: Retrospective, cross-sectional, observational, descriptive and analytical study. The study population consisted of patients older than 18 years of age with a diagnosis of thyroglossal duct cyst, treated with the Sistrunk procedure technique between January 2017 and July 2022. Results: The 31 patients were included. 21 of the female gender and 10 of the female gender. The average age was 41.29 years. The age range with the largest number of patients was 35-50 years. The most frequent presenting symptom was painless cervical enlargement. Comorbidities occurred in 48.37% of the patients. The average size was 3.64×2.59 cm. The most frequent location was the infrahyoid (51.61%). Morbidity was 9.67%, 3 patients presented immediate postoperative complications, of which 2 (6.45%) patients presented bleeding that required urgent surgical reoperation with adequate resolution and 1 (3.23%) patient presented solid dysphagia that was resolved with conservative treatment. No intraoperative or late postoperative complications were recorded. Mortality was nil. The average number of days of hospital stay was 3.06 days. The presence of malignancy was null. Conclusions: Morbidity in this series of patients was 9.67%. Mortality and presence of malignancy were null.

THYROGLOSSAL DUCT CYSTS SURGERY OUTCOMES

Objective Thyroglossal duct cysts are the most common congenital neck mass in the midline of the neck. Cystic formations develop due to the partial or complete lack of obliteration of the thyroglossal duct. It may lead to transformation to malignancy, although rarely. Our study aims to discuss the outcomes, examination findings, clinical features, and treatment methods of 51 patients operated on for thyroglossal duct cysts to contribute to the literature. Methods The 51 cases that underwent surgery (Sistrunk, Cystectomy, Thyroidectomy) with a preliminary diagnosis of thyroglossal duct cyst in ENT and HNS clinics were evaluated retrospectively. The patient's sociodemographic data, main complaints, examination findings, diagnostic methods, surgical techniques, recurrence and complication rates after treatment, and pathology results were analyzed in this study. Results Of the 51 patients, 35 (69%) were adults, and 16 (31%) were children. The most common reason 40 (78%) for admission was swelling in the midline of the neck, less commonly 8 (16%) swelling under the chin, 4 (8%) of patients with an average follow-up of 28 months (max 32; min 8; SD 3 months) were performed revision operations. Surgical treatment has consisted of the Sistrunk procedure (n = 47; 92%), cystectomy (n = 4; 8%), or thyroidectomy (n = 1; 2%). Papillary thyroid carcinoma was diagnosed in 2 (4%) patients, and medullary thyroid carcinoma was in 1 (2%) in our cases. They were no significant differences in gender and age, sociodemographics data. Conclusion Thyroglossal duct cysts should be considered in the differential diagnosis of patients presenting with swelling in the midline of the neck. Sistrunk operation, a safe surgical procedure with the least recurrence rate and a low risk of complications, is recommended as surgical treatment. Keywords: Thyroglossal duct cyst, Midline neck mass, Sistrunk operation

Diagnosing Midline Neck Masses: Comparing Clinical Exam, the SIST Score, and the 4S Algorithm.

To validate and compare novel ultrasound scoring systems for dermoid cysts and thyroglossal duct cysts among pediatric patients. Retrospective study. Tertiary care children's hospital. An electronic medical record query of patients younger than 18 years old who underwent primary excision of a neck mass between January 2005 and February 2022, who underwent preoperative ultrasound, and had final histopathologic diagnosis of either thyroglossal duct cysts or dermoid cysts. This generated 260 results, of which 134 patients met the inclusion criteria. Charts were reviewed for demographic data, clinical impressions, and radiographic studies. Radiologists blindly reviewed ultrasound for SIST score (septae + irregular walls + solid components = thyroglossal), and 4S algorithm (Septations, depth relative to Strap muscles, Shape, Solid parts). Statistical analyses were performed to determine the accuracy of each diagnostic modality. Of 134 patients, 90 (67%) had a final histopathologic diagnosis of thyroglossal duct cysts, and 44 (33%) were dermoid cysts. The accuracy of clinical diagnosis was 52%, and preoperative ultrasound report accuracy was 31%. The 4S and SIST accuracies were each 84%. Both the 4S algorithm and SIST score provide increased accuracy of diagnosis relative to standard preoperative ultrasound assessment. Neither scoring modality was determined to be superior. Further research is warranted in improving the accuracy of preoperative assessments for pediatric congenital neck masses.

Our Surgery Experience with Thyroglossal Ductus Cyst and Fistules

Objective: In this study, we aimed to analyze the clinical symptoms, examination signs, and treatments of 34 patients who were operated on with the diagnosis of thyroglossal duct cyst, together with the literature. Methods: We retrospectively analyzed the medical reports of 34 patients operated on due to a thyroglossal duct cyst in our clinic. The patient’s age, gender, location of the swelling in the neck region and whether they were fistulized, symptoms, USG results, and pathological results were recorded by us. Results: Of the 34 patients, 20 were male, and 14 were female, and their ages ranged from 6 to 48 years (mean 14.3±11.7 years). The most common symptom was swelling in the middle of the neck (82%). Other symptoms were occasional discharge or fistula in the middle of the neck. Swelling or fistula mouth was in the midline of the neck in 28 patients and the paramedian region (4 on the right and two on the left) in 6 patients. In the symptoms of the cases, we see Fistula mouth in 9 and cyst formation in 25 cases. A neck ultrasound was performed on all patients. All our patients underwent a Sistrunk operation. Thyroglossal duct cysts recurred in only two of our patients, and they have been operated on again. The pathology results of all our patients were thyroglossal duct cysts. Conclusion: Thyroglossal duct cysts and fistulas should not be forgotten in the differential diagnosis of patients presenting with inflammatory discharge and swelling in the middle region of the neck. Surgery should be performed to treat thyroglossal duct cysts because of the risk of cancer transformation. Sistrunk operation is in the first place in the treatment. It is the method with minor repetition.

Ectopic thyroid imitating a thyroglossal cyst: A case report

A twelve-year-old male child presented with a midline neck mass for three years that moved with deglutition and tongue protrusion. A clinical diagnosis of thyroglossal duct cyst was made and patient was further evaluated for surgery. Ultrasonography of neck showed an ectopic thyroid tissue with features of chronic thyroiditis superficial to thyroid cartilage and thyroid bed appeared empty. Cytopathology reported Bethesda category 2 features of chronic thyroiditis. Thyroid profile of the patient revealed sub clinical hypothyroidism. On further evaluation withTc-99m pertechnetate scan, it was revealed that this midline neck swelling was in fact the only functioning thyroid tissue, hence no surgery was performed. This case highlighted the importance of ultrasonography along with thyroid scan in the preoperative evaluation of a midline neck swelling.

Thyroglossal duct cyst with hoarseness as the sole symptom and an intralaryngeal extension masquerading as a laryngeal mass: Clinical experience and literature review.

A thyroglossal duct cyst is the most common congenital disease in the neck. There are two age groups usually associated with thyroglossal duct cysts: 1-11years in children and 30-60years in adults. These midline neck masses are typically located anteriorly in the neck, inferior to the hyoid bone. We report an extremely rare case of an intralaryngeal thyroglossal duct cyst without a neck mass, presenting with hoarseness as the sole symptom. A 64-year-old man presented with a 3-month history of hoarseness. On physical examination, no neck mass or swelling was observed during cervical palpation. Laryngostroboscopy revealed a large submucosal mass in the right glottis and supraglottis, and mobility of the right vocal cord was restricted. Surgery was performed via an external approach to completely resect the cyst, together with the middle part of the hyoid bone. Histopathologic examination of the cyst led to a diagnosis of thyroglossal duct cyst. The patient recovered well and his voice returned to normal. Attention should be paid to the occurrence of rare types of thyroglossal duct cyst in unusual clinical sites. Adequate radiological examinations should be performed, and reading the computed tomography or magnetic resonance imaging scans carefully before surgery is important to avoid misdiagnosis.

Efficacy of Ultrasonography in the Diagnosis of Cystic Neck Masses Confirmed By Histopathological Examination

Cystic lesion of the neck is one of the lesions that fall under the umbrella of congenital and acquired neck masses. Ultrasonography plays an important role in the diagnosis of these lesions. The aim of this study is to highlight the efficacy of ultrasonography in the diagnosis of cystic lesions of the neck area.Materials and methods: 43 patients presented with palpable neck mass were examined clinically and scanned by ultrasonography, these patients were divided into three groups according to the histopathological examination of the cystic lesions, group 1 was 32 patients with thyroglossal duct cyst, group 2 was 8 patients with cervical tuberculous lymphadenitis and group 3 was 3 patients with branchial cleft cyst. FNAC was done and the aspirate sent for cytological, bacteriological and biochemical assessments were done for more confirmation. Plain X ray for the chest, Computed tomography (CT) if the lesion is deep seated or to detect the primary neoplastic lesion if great suspicion is present.Results: The accuracy of ultrasonography in the diagnosis of thyroglossal duct cyst was 94.4%, cervical tuberculous lymphadenitis and branchial cleft cyst were 80%.Conclusion: Despite the need for further radiological investigation like CT scan in some patients, ultrasonography remains the first line investigative tool with high sensitivity and specificity.

Preoperative ultrasound for the diagnosis of thyroglossal duct cysts: A validation study

ObjectivesTo evaluate the use of ultrasound to distinguish between thyroglossal duct cysts (TGDC) and dermoid cysts (DC) for surgical planning. To validate the SIST (septae + irregular wall + solid components = TGDC) scoring system proposed by Oyewumi et al. [1]. MethodsThis was a retrospective chart review of pediatric patients with midline neck masses who presented between the years of 2005 and 2014 and underwent preoperative ultrasound and surgical resection. Two pediatric radiologists blinded to diagnosis reviewed each US for 14 separate characteristics. According to the SIST scoring system, one point was given for each of the following: internal septae, irregular walls, and solid components. Results45 patients met inclusion criteria. Final pathologic diagnosis showed 29 patients had TGDC, 16 had DC. The majority of patients with both TGDC and DC earned SIST scores of 0. ConclusionWhile ultrasound remains a useful part of the work-up of lesions of the head and neck in children, this small retrospective study was not able to validate the previously proposed SIST scoring system None of the parameters discussed in the original paper was found to be a statistically significant determinant of TGDC.

Thyroglossal duct cysts: clinicoradiological diagnosis and outcome of surgery

Introduction: Thyroglossal duct cyst (TGDC) is a congenital malformation caused by failure of obliteration of the thyroglossal duct. It presents at any age and often requires surgical excision. This study was done to study our cases of TGDC to get some conclusions that may help the management of such cases.Patients and Methods: This is a prospective study done at the Maxillofacial Surgery Unit, General Surgery Department, Sohag University Hospital, Sohag, Egypt in collaboration with Vascular, Neuro and Interventional Radiology Departments, Faculty of Medicine, Al-Baha University, Kingdom of Saudi Arabia. It included patients with the diagnosis of TGDC who were managed between July 2011 and June 2017. Their charts were reviewed for the demographics, clinical presentations, radiological investigations, management, and outcome.Results: The study included 60 patients; 41 (68.3%) men and 19 (26.7%) women. The age of the patients ranged between 2 and 29 years; 45 (75%) patients were under 10 years. The complaint was neck mass in 49 (81.6%) patients, discharging opening in 11 (18.4%) patients. All cases were primary cases. The cyst or fistula opening was located adjacent to the hyoid bone in 51 (85%) patients, infrahyoid in seven (11.7%) patients, and suprahyoid in two (3.3%) patients. Neck ultrasonography in all patients detected the cyst and its location and assured that the thyroid gland was present in its normal location. These patients were treated by the classical Sistrunk procedure. The follow-up period ranged between 3 and 30 weeks. One patient had recurrence and operated on 1 year later.Conclusion: TGDC is the most common cervical congenital anomaly. It can be found in all age groups, with the highest incidence in pediatric males. Although, it is diagnosed clinically in most of the cases, the use of radiological investigations can improve the diagnosis. The knowledge of embryology, meticulous dissection along anatomical planes, and excision of the core of the hyoid bone is essential to decrease recurrence of TGDC.

Papillary Thyroid Carcinoma within Thyroglossal Duct Cyst: Case Series and Literature Review.

Introduction Thyroglossal duct cyst (TGDC) is the most common congenital anomaly of the neck, and approximately 7% of all the adult population presents it. Ectopic thyroid tissue is found in the thyroglossal duct cyst wall in up to 65% of cases. This thyroid tissue has the potential to develop some type of malignancy, the most common of which is the papillary carcinoma of the thyroid. There are just over 270 cases of thyroglossal duct cyst malignancy reported in the literature. Objectives We aimed to study our population of patients in order to identify cases with thyroglossal duct cyst malignancy. Methods A retrospective chart review was conducted in the section of otolaryngology/head and neck surgery at a hospital in Karachi, Pakistan, from January of 2004 to December of 2014 on patients with the diagnosis of thyroglossal duct cyst. Results Fifty-eight patients were diagnosed with TGDC, two of whom also presented with thyroglossal duct cyst carcinoma. Both patients revealed papillary thyroid carcinoma on histopathology. Case 1 had an open biopsy before undergoing definitive surgery. Both patients underwent subsequent total thyroidectomy after Sistrunk procedure, and case 2 had selective neck dissection revealing lymph node metastasis. Conclusion Thyroglossal duct cyst carcinoma is a rare finding that comes as a surprise to both the patient and the surgeon. We report 2 out of 58 cases diagnosed with thyroglossal duct cyst carcinoma.

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

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.

Diagnostic and Surgical Approach of Thyroglossal Duct Cyst in Children: Ten Years Data Review.

Thyroglossal duct cysts are the most common congenital midline neck swelling in children. To evaluate the clinical features, treatment, incidence of complications and outcomes in children with congenital midline neck lesions and more specifically with thyroglossal duct cyst, treated in our department the last ten years. It is a retrospective study. The aggregated data revealed 59 patients with congenital midline neck lesions, of which 33 patients were with thyroglossal duct cyst (TDC). The diagnosis of TDC was made by physical examination, ultrasound (US) in all cases, and for complicated cases a magnetic resonance imaging (MRI) was performed. In all cases followed histopathological conformation of thyroglossal duct cyst. Fifty nine patients were admitted with midline cystic neck mass and the histopathological evaluation revealed, 33 cases (55.9%) of thyroglossal duct cyst, 14 cases (23.7%) of dermoid cysts, 3 cases (5.1%) of second branchial anomalies, 4 cases (6.7%) of inflammation of unknown cause, 4 cases (6.7%) of lymph nodes and 1 case (1.7%) of capillary skin haemangioma. More specifically, 38 patients were admitted with preoperative diagnosis of thyroglossal duct cyst, but in 5 patients pathological investigation demonstrated the presence of dermoid cyst. The mean age of the 33 patients with TDC at the time of surgery was 6.125 years, ranging between 9 months and 13 years with 10 patients younger than 3 years. Of the 38 patients with initial diagnosis of thyroglossal duct cyst, only four patients (10.5%) had a simple cyst excision and complication rate was 25% (1 case with recurrence). In these patients, the histopathological examination showed that three of them had a dermoid cyst and one had thyroglossal duct cyst. The other 34 patients (89.4%) were treated by Sistrunk's procedure, with two cases (5.9%) were proven on histology to be non TDC. In this group the complication rate was 3.03% (1 case with wound infection). The inappropriate surgical approach due to misdiagnosis or the incomplete surgical procedure remains the impact factor for recurrence. The modification of Sistrunk's procedure remains the main surgical technique that can provides good results with low rate of complication (3.03%) and recurrence (0%) as shown of our collecting data.

Endoscope-assisted concurrent resection of thyroglossal duct cysts and benign thyroid nodules via a small submental incisions

The objective of this study was to evaluate the technique of endoscope-assisted concurrent resection of thyroglossal duct cysts and benign thyroid nodules via a small submental incision. Endoscope-assisted thyroglossal duct cyst excision and subtotal thyroidectomy were performed via a small submental incision in six patients with thyroglossal duct cysts and benign nodular thyroid lesions. The thyroglossal duct cysts and thyroid lesions were completely excised. The incisions were 3-4cm in length, and the mean operation time was 84±11min. The mean volume of blood loss was 19±5mL. Postoperative pathological examination findings confirmed the diagnosis of thyroglossal duct cyst in all patients. The thyroid lesions were nodular goiter in three patients and thyroid adenoma in three patients. No postoperative complications such as hematoma, pharyngeal fistula, hypocalcemia, recurrent laryngeal nerve paralysis, or dysphagia were observed. No changes in the planned surgical procedure were required, and no recurrent lesions were detected during follow-up. In conclusion, patients with thyroglossal duct cysts and benign thyroid lesions can be treated by endoscopic excision via a small submental incision, thereby avoiding large neck incisions and resulting in better postoperative cosmetic outcomes.

Ectopic thyroid in presumed thyroglossal duct cyst

We report a case of an eight year old female child with a midline neck mass for seven years. Since its early presentation, this midline mass has recently increased in size. A presumptive diagnosis of thyroglossal duct cyst was made clinically and planned for surgery. Preoperative evaluation revealed hypothyroidism, hence she was referred to us for the management of the same prior to excision. On further evaluation 99 Tc-thyroid scan showed that this midline mass was in fact the only functioning thyroid tissue and ultrasonography revealed no thyroid tissue in usual location, therefore no surgery was performed. This case demonstrates the essential role of a thyroid scan and ultrasonography in the preoperative evaluation of a midline neck mass.

Comparison of imaging modalities in pediatric thyroglossal duct cysts

To determine and compare the accuracy of different imaging modalities including ultrasound (US), magnetic resonance imaging (MRI), and computed tomography (CT) in the diagnosis of thyroglossal duct cysts (TGDC) in children. Retrospective chart review. A retrospective chart review was performed on patients under the age of 18 years who had undergone surgical excision of midline neck masses between January 2002 and June 2011. All patients had preoperative imaging. Data including age at surgery, preoperative imaging results, and postoperative pathology results were recorded. Preoperative imaging diagnoses were then compared to postoperative pathologic diagnoses. Diagnostic test statistics were performed. A total of 44 patients met the study criteria. There were 15 patients who underwent more than one modality of imaging study. US had a sensitivity of 75% in diagnosis of TGDC. MRI sensitivity was 60% and CT was 82%. None of the tests had high specificity for TGDC; US was the highest at 80%. All three modalities had positive predictive values higher than 90%. US had the highest positive likelihood ratio (3.8), although the 95% confidence interval was not statistically significant. In a comparison of the three most commonly used imaging modalities for pediatric TGDC, US was the preferred exam given its comparable accuracy, ease of administration, and lower cost. In addition, the added risks of general anesthesia with MRI and ionizing radiation with CT are not justified in this setting given their equivalent or inferior performance when compared to US in this cohort.

Endolaryngeal extension of thyroglossal duct cyst

Thyroglossal duct cysts are the most common congenital neck masses that develop during childhood, The masses develop from remnants of thyroglossal ducts, and typically appear as midline neck masses. Endolaryngeal extension of thyroglossal duct cysts has been reported mostly as midline neck swelling. We observed a case of extension of the thyroglossal duct cyst to the supraglottic area without neck swelling. A 50-year-old man presented with a 1-month history of foreign-body sensation in the throat. Fiberscopic and radiologic findings were similar to those associated with a saccular cyst, but its proximity to the hyoid bone raised the possibility of thyroglossal duct cyst. Operation was performed via an external incision to completely remove the cyst. Postoperative fiberscopy revealed that the aryepiglottic fold swelling had disappeared. Diagnosis of thyroglossal duct cyst was confirmed on the basis of pathological findings. In cases in which it is difficult to remove the cyst from the hyoid membrane, the hyoid bone midline portion should be dissected. Thyroglossal duct cysts should be considered in cases with a submucosal tumor in the supraglottic region, and radiological examinations should be performed.

Thyroglossal duct cyst: a comparison between children and adults

Purpose The purpose of the study was to evaluate the differences in the clinical characteristics of thyroglossal duct cysts (TGDC) between children and adults and to find a method for optimizing management of TGDC. Materials and methods This study consisted of a retrospective chart review of patients with a diagnosis of TGDC from 1997 to 2002. All records were reviewed for age and sex, season of first visit, diagnostic methods, sizes and locations of cysts, surgical management, and recurrences. Differences between children and adults were analyzed. Results A total of 84 patients (32 children, 52 adults) were recruited. There were no significant differences in sex in either group. Compared with children, more adult patients had left-sided and infrahyoid cyst locations. The cyst sizes were significantly larger in adults. In this review, 90.4% of adults and 75% of children underwent a Sistrunk operation, whereas the others underwent cyst excision. There was a total of 5 recurrences, 2 in children and 3 in adults. Conclusion Although the recurrence rates between children and adults and between different surgical managements were not significantly different, a Sistrunk procedure is recommended as the main operation of choice, especially in adults in whom a more extended tract resection should be performed.

Surgical management of a thyroglossal duct cyst in a cat

A 14-year-old castrated male domestic shorthair cat was evaluated because of a large fluid-filled mass on the ventral aspect of the neck that failed to resolve after repeated draining. Radiography and computed tomography revealed a fluid-filled mass 13 cm in diameter extending from the level of the first cervical vertebra to the manubrium. No evidence of metastasis was seen. Cytologic examination of the fluid revealed it to be a transudate with a T4 concentration considered to be normal. Incisional biopsy of the cyst wall was performed and led to a diagnosis of thyroglossal duct cyst. The cyst was excised, and no recurrence was observed 15 months after surgery. Aside from temporary seroma formation, no complications developed after the surgery. A distinct tract through the hyoid apparatus to the base of the tongue, as has been described in humans, was not identified. Thyroglossal duct cyst should be considered as a differential diagnosis in cats with masses on the ventral aspect of the neck. Complete excision appeared to be curative in the cat of this report.

An Intra-Thyroid Thyroglossal Duct Cyst

Thyroglossal duct cysts can be found in several different locations, although intra-thyroid presentations are rare. We present the case of an 11-year-old patient with a visible neck mass on the right thyroid lobe. On sonogram, it was consistent with a unilocular cyst measuring 2 centimeters in diameter. The cyst did not take up the radioisotope during a gammagram. Fine needle aspiration cytology suggested a diagnosis of thyroglossal duct cyst. At surgery, we found that there were no lesion-dependent thyroglossal tracts; we therefore performed a simple enucleation of the cyst, sparing the rest of the gland. The pathologic examination confirmed that it was an intra-thyroid thyroglossal duct cyst. After 8 months of follow-up, the patient has remained without complications of any kind or recurrence. Only four prior cases of intra-thyroid thyroglossal cysts have been described in the pediatric population. Half of them presented with a typical thyroglossal tract crossing the hyoid and the other half presented an isolated cyst. It is highly unlikely that a cold, cystic, thyroid mass in a child is a thyroglossal duct cyst. Diagnosis is made on the basis of fine needle aspiration cytology and the lesion is treated surgically. A thyroglossal tract must be methodically sought out during intervention, although they frequently do not exist.

Complications associated with the Sistrunk procedure.

To assess the type and rate of complications in the postoperative period of pediatric patients undergoing the Sistrunk procedure. A retrospective review of patients with a diagnosis of thyroglossal duct cyst who had not had corrective surgery previously. An attempt to standardize the study was made as follows: all patients had surgery under the direction of one surgeon, using the Sistrunk procedure with minor modifications from its original description. Complications were divided into major and minor categories. Charts were reviewed for age, sex, preoperative assessment, and postoperative follow-up. Complications were recorded. A postoperative telephone survey was conducted. A minor complication rate of 29% was observed. There were no recurrences or major complications. The Sistrunk procedure remains the operation of choice for removal of the thyroglossal duct cyst. When the surgery is properly performed, with attention to key surgical landmarks, the risk of major complication is minimal. Complications that do occur are minor and wound related.