Management of thyroglossal duct cysts in children.
BACKGROUND
The recurrence rate of thyroglossal duct cysts removed by Sistrunk or other procedures is 4% and 50%, respectively. The aim of the present study was to explain the reasons for recurrence and misdiagnosis.


METHODS
Twenty-seven children underwent surgery for thyroglossal cysts and fistulas during 1989-2000. Age, sex, length of history, presentation, preoperative investigations, operative findings, histopathology of the lesion and length of excised hyoid bone, postoperative complications and length of follow-up were recorded. Statistical analysis was performed using Fisher's exact test with a significance level of P < 0.05.


RESULTS
Twenty-three patients were primary referrals and four were secondary referrals having had previous surgery with misdiagnosis. The recurrence rate after a Sistrunk procedure was similar to the rate indicated in the literature (3.7%); however, no related special features could be identified such as inflammation (n = 12), perforation at surgery (n = 7), presentation with fistula (n = 4) or previous drainage of abscess (n = 5) (P > 0.05).


CONCLUSIONS
Misdiagnosis is the most common cause of inadequate and inappropriate surgery, leading to recurrence of the lesion. The authors recommend a Sistrunk procedure for all cases of suspected thyroglossal duct cysts.
Türkyilmaz
Zafer
Z
Department of Pediatric Surgery, Gazi University Medical Faculty, Ankara, Turkey.
Sönmez
Kaan
K
Karabulut
Ramazan
R
Demirgoullari
Billur
B
Sezer
Cem
C
Basaklar
A Can
AC
Kale
Nuri
N
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003951:Diagnostic Errors / Q000517:prevention & control; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D055502:Secondary Prevention; D013955:Thyroglossal Cyst / Q000175:diagnosis* / Q000601:surgery*; D017211:Treatment Failure; D014421:Turkey