[First-intention surgical treatment of thyroglossal duct cysts in children: apropos of 99 cases].
BACKGROUND
Thyroglossal duct cyst (TGDcs) is the most common malformation of the neck. The risk of infection and malignant transformation impose its treatment.


OBJECTIVE
The purpose of our study were: 1) to specify some points about the symptomatology and preoperative evaluation necessary for TGDcs diagnosis; 2) to analyse the factors who can explain an unsuccessful surgical treatment.


METHODS
Our study is based on a retrospective review of cases and a review of the literature. From 1981 to 2000, 99 children with a mean age of five years were treated for a TGDcs with a surgical procedure in the Grenoble University Hospital. 3 excision and 96 Sistrunck's procedure were performed. In all cases a histological study was made.


RESULTS
Ultrasonography was the most frequent preoperative evaluation. We have had 7 complications: 3 haematoma, 2 abscess and 2 desunited scar. 6 children have had recurrent disease. Among these 6 children, 3 have had an excision and 3 a Sistrunck's procedure. No case of malignant transformation was reported.


CONCLUSIONS
Ultrasonography is the first preoperative evaluation to obtain before surgical treatment of a TGDcs. Sistrunck's procedure is the best surgical treatment with a value of recurrence from 1% to 10%. Areas of surgical failure included breaking of cyst during the dissection, inadequate hyoïd bone resection, an anatomical variation with many ductuli in the base of tongue, inadequate muscles of tongue resection.
Righini
C A
CA
CHU de Grenoble, Service ORL, BP 217, F-38043 Grenoble, France. CRighini@chu-grenoble.fr
Mouret
P
P
Blanchet
C
C
Piolat
C
C
Dyon
J F
JF
Reyt
E
E
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012737:Sex Factors; D013955:Thyroglossal Cyst / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000196:embryology / Q000601:surgery*; D014463:Ultrasonography