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A 16-year experience in treating thyroglossal duct cysts with a “conservative” Sistrunk approach

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Abstract

Although Sistrunk operation is the standard method to treat thyroglossal duct cyst, the reported recurrence rates after a “classic” or “modified” Sistrunk procedure still varied from 0 to 15.8 %, indicating the existence of some technical uncertainties. While simple cystectomy has been recognized as the most important prognostic factor predicting thyroglossal duct cyst recurrence, whether other clinico-pathological parameters also affect disease recurrence has not been well studied. We retrospectively reviewed the medical records of all patients who underwent thyroglossal duct cyst surgery between June 1998 and June 2014 at our institution. Among the 180 primary patients, 160 patients received a “conservative” Sistrunk operation, while the remaining 20 patients received simple cystectomy only. Five patients (2.8 %, 5/180) had recurrence. Four of them received simple cystectomy while 1 had “conservative” Sistrunk operation. In univariable analysis, age (p = 0.02), history of previous infection (p = 0.004) and the type of resection (p = 0.001) were significantly correlated with disease recurrence. In multivariable analysis, the type of resection turned out to be the most important factor (p = 0.03) related to recurrence. In the most parsimonious model selected by backward elimination, both history of infection (p = 0.048) and the type of resection (p = 0.02) were important predictors of postoperative recurrence. Our results demonstrated that a “conservative” Sistrunk approach could provide a comparably low recurrence rate (0.6 %, 1/160) in dealing with primary thyroglossal dust cysts. Routine dissection of suprahyoid tissue may not be imperative. Overall, the type of resection and history of infection are the most important predictors of recurrence for thyroglossal duct cyst.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study protocol was reviewed and approved by the Institutional Human Experiment and Ethic Committee (A-ER-103-102). For this type of study (retrospective chart review), formal consent is not required.

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Authors and Affiliations

  1. Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Yuan-Shin Zhu, Chun-Yen Ou, Jiunn-Liang Wu, Wen-Yuan Chao, Sen-Tien Tsai, Sheen-Yie Fang, Cheng-Chih Huang, Wei-Ting Lee & Jenn-Ren Hsiao

  2. Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Chung-Ta Lee

  3. National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan

    Jeffrey S. Chang

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  1. Yuan-Shin Zhu
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Correspondence to Jenn-Ren Hsiao.

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Zhu, YS., Lee, CT., Ou, CY. et al. A 16-year experience in treating thyroglossal duct cysts with a “conservative” Sistrunk approach. Eur Arch Otorhinolaryngol 273, 1019–1025 (2016). https://doi.org/10.1007/s00405-015-3571-3

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  • DOI: https://doi.org/10.1007/s00405-015-3571-3

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