Hirshoren Nir, Neuman Tzahi, Udassin Raphael, Elidan Josef, Weinberger Jeffrey M
Department of Otolaryngology-Head and Neck Surgery, Hebrew University School of Medicine-Hadassah Medical Center, Jerusalem, Israel.
Otolaryngol Head Neck Surg. 2009 Mar;140(3):338-42. doi: 10.1016/j.otohns.2008.12.002.
Analysis of the pre- and postoperative features, long-term follow-up, and complications.
Case series with chart review of 160 thyroglossal tract remnant excisions over a 20-year period (1988-2007).
The mean age of diagnosis was 10.9 +/- 14.2 years with 63.8 percent male predominance. There was a prior history of thyroglossal tract remnant infections in 70 percent of patients, and 30 percent presented with cutaneous fistulas. The majority had ultrasound imaging that identified cysts mainly (66.7%) in the infrahyoid region. Preoperative fine-needle aspirations in 18 patients were benign. On pathological reevaluation, 26.5 percent had thyroid tissue inside the remnant, with one case of papillary carcinoma. After the Sistrunk operation, postoperative complications occurred in 7.5 percent including a 1.9 percent recurrence rate.
All age groups had similar clinical presentations and outcomes. Ultrasound is a reliable and appropriate imaging modality for most patients. Surgery must effectively incorporate the tract and cyst to allow low recurrence rates (<2%). Clinically diagnosed thyroglossal tract remnant may, in fact, be other pathologies in 10 percent of cases. Nevertheless, our recommendation is a Sistrunk procedure for all midline neck lesions suspected to be a thyroglossal tract remnant.
分析术前和术后特征、长期随访情况及并发症。
病例系列研究，回顾了20年间（1988 - 2007年）160例甲状舌管残余切除术的病历。
诊断时的平均年龄为10.9±14.
2岁，男性占63.8%。70%的患者有甲状舌管残余感染史，30%的患者有皮肤瘘。大多数患者的超声检查发现囊肿主要（66.7%）位于舌骨下区域。18例患者术前细针穿刺结果为良性。经病理重新评估，26.5%的残余物内有甲状腺组织，其中1例为乳头状癌。行Sistrunk手术后，术后并发症发生率为7.5%，复发率为1.9%。
各年龄组的临床表现和结果相似。超声对大多数患者是一种可靠且合适的影像学检查方法。手术必须有效地切除管道和囊肿，以降低复发率（<2%）。临床上诊断为甲状舌管残余的病例，实际上有10%可能是其他病变。尽管如此，我们建议对所有怀疑为甲状舌管残余的中线颈部病变均采用Sistrunk手术。
