Patigaroo Suhail Amin, Dar Nisar Hussain, Jallu Aleena Shafi, Ahmad Rauf
Postgraduate Department of ENT, HNS, Government Medical College, Srinagar, Jammu and Kashmir India.
Indian J Otolaryngol Head Neck Surg. 2017 Mar;69(1):102-107. doi: 10.1007/s12070-016-1029-6. Epub 2016 Oct 27.
Thyroglossal cyst is the most common congenital neck mass and occurs in 7% of the population. They occur due to failure of thyroglossal duct to involute and atrophy thyroglossal duct cysts often occur in pediatric patients. Majority of them are found infrahyoid region. The purpose of the present study is to report our 5 year clinical experience of thyroglossal cysts in terms of clinical features and surgical findings with special emphasis on naked eye extend of patent thyroglossal duct when present. To the best of our knowledge this is first clinical study which has reported the extend of thyroglossal duct on naked eye. This prospective observational study was done in the Postgraduate Department of ENT, Head and Neck surgery of Government medical college, Srinagar for a period of five years from January 2011 to January 2016. Thirty patients of histopathologically confirmed thyroglossal cysts were enrolled in the study. Patients were initially diagnosed on the basis of clinical history, examination and USG findings suggestive of cyst. Clinical data and surgical data in terms of size and location of cyst, presence or absence of thyroglossal duct etc. was analyzed and formulated in tables for patients who had histopathologically confirmed cyst. Mean age was 10 years. Majority (73.3%) were less than 15 years of age. Males were 22 in number (73.3%) while females compromised 26.7% of population. Ninety percent of patients presented with neck swelling. Erythema/redness over swelling was seen in 13.3% of patients. Majority (83.3%) of cysts were subhyoid in location. Thyroglossal ducts were seen to be patent for different lengths and areas. Majority of patients (80%) had tract arising from cyst and disappearing at superior border of hyoid body while three patients (10%) had patent thyroglossal duct from cyst to vallecular mucosa. A complete patent thyroglossal duct was seen in one patient (3.3%) from cyst to base of tongue. Complete Absent tract was seen in two patients (6.7%). Majority (70%) of cysts were having size between 1.6 and 3 cm. Intraoperative 10% of cyst got ruptured. Thyroglossal cysts are most commonly seen in pediatric males. Most of them present with visible midline neck swelling. In few cases cyst can rupture after repeated infections leading to sinus formation. Most of them are subhyoid in location. These cysts are usually of size 1.5-3 cm. Complete patent thyroglossal duct from cyst to tongue musculature is rarely seen while most of the times, a patent duct just disappears at the superior border of body of hyoid. None of our cysts had malignant features.
甲状舌管囊肿是最常见的先天性颈部肿块，在7%的人群中出现。它们是由于甲状舌管未能退化和萎缩而形成的，甲状舌管囊肿常见于儿科患者。大多数囊肿位于舌骨下区域。本研究的目的是报告我们5年来甲状舌管囊肿的临床经验，包括临床特征和手术发现，特别强调存在时甲状舌管肉眼可见的延伸范围。据我们所知，这是第一项报告甲状舌管肉眼延伸范围的临床研究。这项前瞻性观察性研究于2011年1月至2016年1月在斯利那加政府医学院耳鼻喉科、头颈外科研究生部进行了5年。30例经组织病理学确诊的甲状舌管囊肿患者纳入研究。患者最初根据临床病史、检查和超声检查结果提示囊肿进行诊断。对经组织病理学确诊囊肿的患者，分析其临床数据和手术数据，包括囊肿大小、位置、甲状舌管是否存在等，并制成表格。平均年龄为10岁。大多数（73.3%）患者年龄小于15岁。男性22例（73.3%），女性占26.7%。90%的患者表现为颈部肿胀。13.3%的患者肿胀处有红斑/发红。大多数（83.3%）囊肿位于舌骨下。甲状舌管可见不同长度和区域的通畅情况。大多数患者（80%）的管道起源于囊肿，在舌骨体上缘消失，而3例患者（10%）的甲状舌管从囊肿到会厌黏膜通畅。1例患者（3.3%）从囊肿到舌根可见完整通畅的甲状舌管。2例患者（6.7%）未见管道。大多数（70%）囊肿大小在1.6至3厘米之间。术中10%的囊肿破裂。甲状舌管囊肿最常见于儿科男性。大多数患者表现为可见的颈部中线肿胀。少数情况下，囊肿反复感染后可破裂形成窦道。大多数囊肿位于舌骨下。这些囊肿通常大小为1.5 - 3厘米。从囊肿到舌肌组织的完整通畅的甲状舌管很少见，而大多数情况下，通畅的管道在舌骨体上缘就消失了。我们的囊肿均无恶性特征。
