Modified Sistrunk procedure in a pediatric population: Infected thyroglossal duct cysts as a risk factor for recurrence and review of the literature.

AIM

To analyze the rate of recurrence and possible risk factors after surgical treatment in pediatric patients with thyroglossal ductus cyst (TGDC), who underwent the Modified Sistrunk Procedure (MSP).

DESIGN

Retrospective study.

INSTITUTION

The pediatric otorhinolaryngology clinic of a university.

MATERIALS AND METHODS

The study included a total of 251 pediatric patients aged between 2 and 17 years, whose histopathological diagnosis was confirmed and who underwent MSP due to TGDC over a period of 10 years from January 2009 to December 2019. The chi-square test was used to determine the relationship between the independent variables and the dependent variables. Parameters used in the study: The parameters were age, gender, the history of infected TGDC before surgery (cellulitis, abscess), incision and drainage in patients with abscess, number of cysts detected in ultrasonographic imaging, postoperative histopathology, and the number of recurrences.

RESULTS

The study included a total of 251 pediatric patients. The mean age of the children was 6.2 years (2-17 years), the mean follow-up period was 4.8 years (2-6 years), and 38 (15.13%) recurrences were observed after 251 MSP applications. Five risk factors were found to be statistically significant in terms of recurrence rates (p<0.05). These risk factors were surgery during the school period (6-10 years), history of infected TGDC, abscess formation, incision/drainage before MSP, and multicystic cyst in ultrasonographic evaluation.

CONCLUSION

The main determinant for the five significant risk factors among the causes of MSP recurrence is a history of infected TGDC before surgery. When there is no history of TGDC infection in pediatric patients before surgery, surgery should be planned under appropriate conditions before infection occurs. The risk of infected TGDC, cellulitis, and abscess formation increases at school age in particular due to frequent upper respiratory tract infections. When there is a cyst infection, antibiotic treatment should be applied, and incision and drainage should be avoided as much as possible in the presence of an abscess.