Department of Otolaryngology Head and Neck Surgery, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey.
Int J Pediatr Otorhinolaryngol. 2021 Sep;148:110837. doi: 10.1016/j.ijporl.2021.110837. Epub 2021 Jul 12.
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).
Retrospective study.
The pediatric otorhinolaryngology clinic of a university.
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.
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.
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.
分析经改良 Sistrunk 术（MSP）治疗儿童甲状舌管囊肿（TGDC）患者的复发率及可能的危险因素。
回顾性研究。
某大学儿科耳鼻喉科诊所。
本研究共纳入 251 例 2 至 17 岁的儿童患者，这些患者的组织病理学诊断均为 TGDC，并于 2009 年 1 月至 2019 年 12 月期间因 TGDC 接受 MSP 治疗。采用卡方检验来确定自变量和因变量之间的关系。研究中使用的参数：年龄、性别、手术前 TGDC 感染史（蜂窝织炎、脓肿）、脓肿患者的切开引流、超声影像学检查发现的囊肿数量、术后组织病理学检查和复发次数。
本研究共纳入 251 例儿科患者。患儿的平均年龄为 6.2 岁（2-17 岁），平均随访时间为 4.8 年（2-6 年），251 例 MSP 应用后观察到 38 例（15.13%）复发。有 5 个危险因素在复发率方面具有统计学意义（p<0.05）。这些危险因素包括：在校期间（6-10 岁）手术、术前 TGDC 感染史、脓肿形成、MSP 前切开/引流以及超声评估中的多房性囊肿。
MSP 复发的五个显著危险因素的主要决定因素是术前 TGDC 感染史。当患儿术前无 TGDC 感染史时，应在感染发生前择期进行手术。在特定时期，尤其是在学龄期，由于上呼吸道感染频繁，感染性 TGDC、蜂窝织炎和脓肿形成的风险增加。当存在囊肿感染时，应进行抗生素治疗，并尽量避免脓肿形成时的切开引流。
