Ibrahim Farid F, Alnoury Mohammed K, Varma Namrata, Daniel Sam J
Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, QC, Canada.
Department of Otolaryngology-Head and Neck Surgery, The Montreal Children's Hospital, McGill University, Montreal, QC, Canada.
Int J Pediatr Otorhinolaryngol. 2015 Jun;79(6):863-867. doi: 10.1016/j.ijporl.2015.03.019. Epub 2015 Mar 28.
Management of recurrent thyroglossal duct cysts (TGDC) remains a clinical challenge to otolaryngologists--head and neck surgeons. The purpose of this systematic review is to determine the best surgical management for recurrent TGDC.
A comprehensive search for relevant articles was carried out on electronic databases named Ovid Medline, Ovid Medline in process and Other Non-Indexed Citations, Embase, Ovid OldMedline, and Ovid Medline Daily. Articles published in English until 2014 were eligible for review. Using predefined inclusion criteria, published articles on surgical outcomes in the management of recurrent thyroglossal duct cyst, were selected, reviewed, and their findings synthesized.
Nine studies met the inclusion criteria for this systematic review comprising a total of 66 patients who underwent 114 secondary surgeries. Better outcomes were observed with en bloc neck dissection vs. a revision Sistrunk with a recurrence rate of 20% vs. 30.12% respectively. In addition two new surgical approaches, suture-guided transhyoid pharyngotomy and Koempel's suprahyoid technique reported 100% success rate.
Recurrence after primary surgical management remains a clinical challenge. We highlight the outcomes of the 4 main surgical techniques reported in the literature, repeat Sistrunk procedure, en bloc neck dissection, suture-guided transhyoid pharyngotomy, and Koempel's suprahyoid technique. Although this review reports a 100% success rate with the 2 latter techniques, further prospective studies and additional experience with these same techniques by other surgeons/institutions with or without a randomized trial could provide additional confirmation of improved outcomes using these specific surgical procedures.
复发性甲状舌管囊肿（TGDC）的管理对耳鼻咽喉科——头颈外科医生来说仍是一项临床挑战。本系统评价的目的是确定复发性TGDC的最佳手术管理方法。
在名为Ovid Medline、Ovid Medline正在处理的文献及其他未索引引文、Embase、Ovid OldMedline和Ovid Medline Daily的电子数据库中全面检索相关文章。截至2014年发表的英文文章符合纳入审查标准。使用预先定义的纳入标准，选择、审查已发表的关于复发性甲状舌管囊肿管理中手术结果的文章，并综合其研究结果。
9项研究符合本系统评价的纳入标准，共66例患者接受了114次二次手术。整块颈部清扫术与改良Sistrunk手术相比效果更好，复发率分别为20%和30.12%。此外，两种新的手术方法，即缝线引导经舌骨咽切开术和Koempel舌骨上技术的成功率为100%。
初次手术管理后的复发仍是一项临床挑战。我们重点介绍了文献中报道的4种主要手术技术的结果，即重复Sistrunk手术、整块颈部清扫术、缝线引导经舌骨咽切开术和Koempel舌骨上技术。尽管本评价报告后两种技术的成功率为100%，但其他外科医生/机构通过进一步的前瞻性研究以及使用这些相同技术的更多经验（无论有无随机试验），可以为使用这些特定手术程序改善结果提供更多证实。
