THYROGLOSSAL DUCT CYST - OLD AND NEW SURGICAL APPROACH

  • A. VASILESCU “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania
  • C. BRADEA “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania
  • Mihaela BLAJ “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania
  • Felicia CRUMPEI “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania
  • Delia RUSU “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania
  • Madalina PALAGHIA “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania
  • N. DANILA “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania
  • C.D. LUPASCU “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania

Abstract

The thyroglossal duct cyst (TDC) results from a failure in obliterating the embryogenic duct produced during thyroid migration and it represents the most common type of developmental cyst encountered in the neck region. Material and methods: In the First Surgical Clinic from “Sf. Spiridon” County Clinical Emergency Hospital Iasi, Iasi, between 1998 to 2021, 21 patients with thyroglossal duct cyst were diagnosed and treated. All medical records were reviewed. Results: The thyroglossal duct cysts are located as midline cysts of the neck in all cases. The mean age was 39.2 years (13-66 years). The treatment performed was a variant of Sistrunk’s procedure in which the thyroglossal tract was excised to a variable extent, with central hyoidectomy. The size of the cyst ranged from 1.2 to 4 cm (mean 2.6 cm). Postoperative course was uneventful in all cases. No recurrence was recorded in this series. We describe a case, a 42 years old women, with asymptomatic mass in the anterior part of the neck found a 6 months before, when the patient was referred us with lithiasic obstructive jaundice (we performed ERCP + laparoscopic cholecystectomy). The treatment performed was a variant of Sistrunk’s procedure in which the thyroglossal tract was excised by minimally invasive video-assisted approach, variation of Miccoli’s technique. Postoperative course was uneventful. The follow-up 1 and 2 years no recorded recurrence and thyroid scintigraphy was normal. Conclusions: The standard surgical approach to TDC is Sistrunk’s operation with low recurrence rates. Although the results and the operative time are the same as in traditional surgery, minimally invasive video-assisted approach has better cosmetic result and a less painful course.

Author Biographies

A. VASILESCU, “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania

First Surgical Clinic
“Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
Faculty of Medicine
Department of Surgery (I)

C. BRADEA, “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania

First Surgical Clinic
“Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
Faculty of Medicine
Department of Surgery (I)

Mihaela BLAJ, “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania

First Surgical Clinic
“Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
Faculty of Medicine
Department of Surgery (I)

Felicia CRUMPEI, “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania

First Surgical Clinic
“Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
Faculty of Medicine
Department of Surgery (I)

Delia RUSU, “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania

First Surgical Clinic
“Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
Faculty of Medicine
Department of Surgery (I)

Madalina PALAGHIA, “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania

First Surgical Clinic
“Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
Faculty of Medicine
Department of Surgery (I)

N. DANILA, “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania

First Surgical Clinic

C.D. LUPASCU, “Sf. Spiridon” County Clinical Emergency Hospital of Iasi, Romania

First Surgical Clinic
“Grigore T. Popa” University of Medicine and Pharmacy Iasi, Romania
Faculty of Medicine
Department of Surgery (I)

References

1. Târcoveanu E, Niculescu D, Cotea E, et al. Thyroglossal duct cyst. Jurnalul de Chirurgie 2009; 5 (1): 45-51.
2. Kovacić M, Nekić I. Thyroglossal duct cyst in hyoid bone. Lijec Vjesn 2006; 128(1-2): 23-24.
3. Gioacchini FM, Alicandri-Ciufelli M, Kaleci S, Magliulo G, Presutti L, Re M. Clinical presentation and treatment outcomes of thyroglossal duct cysts: a systematic review. Int J Oral Maxillofac Surg 2015; 44(1): 119-126.
4. Bradea C. Video assisted thyroidectomy. Jurnalul de Chirurgie 2009; 5(1): 86-88.
5. Huang Z, Guo W, Zhou B, Chen X. Minimally Invasive Endoscopic Surgery of Thyroglossal Duct Cysts. J Laparoendosc Adv Surg Tech A. 2015; 25(11): 892-896.
6. Woo SH, Park JJ, Hong JC, et al. Endoscope-assisted transoral removal of a thyroglossal duct cyst using a frenotomy incision: A prospective clinical trial. Laryngoscope 2015;125(12): 2730-2735.
7. Han P, Liang F, Cai Q, Chen R, Yu S, Huang X. Endoscope-assisted resection of thyroglossal duct cysts via a submaxillary vestibular approach. Head Neck 2018; 40(2): 377-383.
8. Byeon HK, Ban MJ, Lee JM, Ha JG, Kim ES, Koh YW, Choi EC. Robot-assisted Sistrunk’s operation, total thyroidectomy, and neck dissection via a trans axillary and retro auricular (TARA) approach in papillary carcinoma arising in thyroglossal duct cyst and thyroid gland. Ann Surg Oncol 2012; 19(13): 4259-4261.
9. Ramirez Plaza CP, Dominguez López ME, Garcia Carrasco CE, Meseguer LM, Fuente Perucho A de la. Management of well differentiated thyroglossal remnant thyroid carcinoma: time to close the debate? Report of five new cases and proposal of a definitive algorithm for treatment. Ann Surg Oncol 2006; 13(5): 745-752.
10. Miccoli P, Minuto MN, Galleri D, Puccini M, Berti P. Extent of surgery in thyroglossal duct carci-noma: reflections on a series of eighteen cases. Thyroid 2004; 14(2): 121-123.
11. Bakkar S, Macerola E, Aljarrah Q, et al. BRAFV600E mutation: a potential predictor of more than a Sistrunk’s procedure in patients with thyroglossal duct cyst carcinoma and a normal thyroid gland. Updates Surg 2019; 71(4): 701-704.
Published
2021-09-30