title: Thyroglossal duct remnant surgery: a reliable, reproducible approach to the suprahyoid region.
abstract: BACKGROUND
  Recurrence of thyroglossal duct remnants remains a clinical problem despite the success of the Sistrunk procedure. Inadequate excision of disease in the suprahyoid region significantly impacts disease recurrence. The primary aim of this study is to describe and present the author's experience with a simple, reliable, and reproducible approach to the suprahyoid area in a Sistrunk procedure.
  
  
  METHODS
  A retrospective review of the surgical management of thyroglossal duct remnants by a single surgeon at the Children's Hospital Los Angeles over a 16-year period was performed. Demographic and clinical data including disease recurrence and other complications were collected. Recurrence rates before and after the consistent application of a modified Sistrunk procedure were compared.
  
  
  RESULTS
  94 patients (54% female and 46% male; mean age 5.2 years) met the inclusion criteria for this study. Overall recurrence rate following a Sistrunk procedure was 2.2%; 11.1% prior to 2004 and 0% after 2004, following consistent implementation of the surgical approach to the suprahyoid region as detailed in this study. Complications were minor and mean follow-up was 5.4 months.
  
  
  CONCLUSIONS
  The author has described a simple, reproducible, and reliable approach to the suprahyoid area in a Sistrunk procedure that limits incomplete excision with minimal risk for complications. This approach to the suprahyoid region should be considered for routine use in the management of both primary and revision thyroglossal duct remnants.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Children's Hospital Los Angeles, 4650 Sunset Boulevard Mail Stop #58, Los Angeles, CA 90027, United States. Electronic address: jkoempel@chla.usc.edu.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Koempel
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013955:Thyroglossal Cyst / Q000601:surgery*
keywords: Recurrence thyroglossal duct cyst and sinus; Revision Sistrunk procedure; Sistrunk procedure; Suprahyoid region; Thyroglossal duct cyst and sinus