Sistrunk centennial: Evolution of a classic operation.

OBJECTIVES/HYPOTHESIS: To trace the evolution of the Sistrunk procedure.

STUDY DESIGN

Historical review.

METHODS

We reviewed historical materials in the English, French, and German literature including journal articles, book chapters, genealogical sources, and obituaries to identify the emerging concepts leading to the Sistrunk operation. These included references to the embryology of the thyroid and of the branchial apparatus as well as incremental advances in the surgical management of midline congenital cervical cysts and fistulae. PubMed, the Google Internet search engine, Archive.org, and Google Translate were primary investigational tools.

RESULTS

Understanding of human embryology evolved rapidly in the mid and late 1800s. Discovery of the thyroglossal duct and its role in thyroid development led to improvements in existing surgery for thyroglossal duct remnants. Sistrunk was aware of the anatomy and histopathology of these remnants and used this knowledge to refine existing surgical approaches.

CONCLUSIONS

The elements of thyroglossal duct remnant surgery existed for decades before Sistrunk popularized his modified approach to dissection of the suprahyoid portion of the tract. His innovation and his clear description of the operation made it accessible to surgeons around the world.

LEVEL OF EVIDENCE

NA Laryngoscope, 130:E45-E47, 2020.