title: Diagnostic and Surgical Approach of Thyroglossal Duct Cyst in Children: Ten Years Data Review.
abstract: BACKGROUND
  Thyroglossal duct cysts are the most common congenital midline neck swelling in children.
  
  
  OBJECTIVE
  To evaluate the clinical features, treatment, incidence of complications and outcomes in children with congenital midline neck lesions and more specifically with thyroglossal duct cyst, treated in our department the last ten years. It is a retrospective study.
  
  
  METHODS
  The aggregated data revealed 59 patients with congenital midline neck lesions, of which 33 patients were with thyroglossal duct cyst (TDC). The diagnosis of TDC was made by physical examination, ultrasound (US) in all cases, and for complicated cases a magnetic resonance imaging (MRI) was performed. In all cases followed histopathological conformation of thyroglossal duct cyst.
  
  
  RESULTS
  Fifty nine patients were admitted with midline cystic neck mass and the histopathological evaluation revealed, 33 cases (55.9%) of thyroglossal duct cyst, 14 cases (23.7%) of dermoid cysts, 3 cases (5.1%) of second branchial anomalies, 4 cases (6.7%) of inflammation of unknown cause, 4 cases (6.7%) of lymph nodes and 1 case (1.7%) of capillary skin haemangioma. More specifically, 38 patients were admitted with preoperative diagnosis of thyroglossal duct cyst, but in 5 patients pathological investigation demonstrated the presence of dermoid cyst. The mean age of the 33 patients with TDC at the time of surgery was 6.125 years, ranging between 9 months and 13 years with 10 patients younger than 3 years. Of the 38 patients with initial diagnosis of thyroglossal duct cyst, only four patients (10.5%) had a simple cyst excision and complication rate was 25% (1 case with recurrence). In these patients, the histopathological examination showed that three of them had a dermoid cyst and one had thyroglossal duct cyst. The other 34 patients (89.4%) were treated by Sistrunk's procedure, with two cases (5.9%) were proven on histology to be non TDC. In this group the complication rate was 3.03% (1 case with wound infection).
  
  
  CONCLUSIONS
  The inappropriate surgical approach due to misdiagnosis or the incomplete surgical procedure remains the impact factor for recurrence. The modification of Sistrunk's procedure remains the main surgical technique that can provides good results with low rate of complication (3.03%) and recurrence (0%) as shown of our collecting data.
authors.affiliation: Paediatric Surgeon, 2 Department of Paediatric Surgery, Aristotle University of Thessaloniki, General Hospital "PAPAGEORGIOU" , Thessaloniki, Greece .
authors.forename: Chrysostomos
authors.initials: C
authors.lastname: Kepertis
authors.affiliation: Resident in Paediatric Surgery, 2 Department of Paediatric Surgery, Aristotle University of Thessaloniki, General Hospital "PAPAGEORGIOU" , Thessaloniki, Greece .
authors.forename: Kleanthis
authors.initials: K
authors.lastname: Anastasiadis
authors.affiliation: Paediatric Surgeon, 2 Department of Paediatric Surgery, Aristotle University of Thessaloniki, General Hospital "PAPAGEORGIOU" , Thessaloniki, Greece .
authors.forename: Vassilis
authors.initials: V
authors.lastname: Lambropoulos
authors.affiliation: Paediatric Surgeon, 2 Department of Paediatric Surgery, Aristotle University of Thessaloniki, General Hospital "PAPAGEORGIOU" , Thessaloniki, Greece .
authors.forename: Vassilis
authors.initials: V
authors.lastname: Mouravas
authors.affiliation: Assistant Professor, Chief of the 2 Department of Paediatric Surgery, Aristotle University of Thessaloniki, General Hospital "PAPAGEORGIOU" , Thessaloniki, Greece .
authors.forename: Ioannis
authors.initials: I
authors.lastname: Spyridakis
keywords: Congenital; Neck; Sistrunk
references.citation: Arch Otolaryngol. 1983 Jan;109(1):34-6
references.pmid: 6848104
references.citation: J R Soc Med. 2000 Jan;93(1):18-21
references.pmid: 10700841
references.citation: Arch Otolaryngol Head Neck Surg. 1998 May;124(5):597-9; discussion 600-1
references.pmid: 9604990
references.citation: Laryngoscope. 2012 Jun;122(6):1405-8
references.pmid: 22460362
references.citation: Otolaryngol Head Neck Surg. 1999 Nov;121(5):543-7
references.pmid: 10547467
references.citation: J Pediatr Surg. 1984 Oct;19(5):555-61
references.pmid: 6502427
references.citation: Otolaryngol Head Neck Surg. 2009 Mar;140(3):338-42
references.pmid: 19248939
references.citation: J Pediatr Surg. 1992 Jun;27(6):710-3
references.pmid: 1501029
references.citation: J Am Coll Surg. 2002 Mar;194(3):274-7
references.pmid: 11893130
references.citation: Ann Surg. 1920 Feb;71(2):121-122.2
references.pmid: 17864229
references.citation: Am J Surg. 1986 Dec;152(6):602-5
references.pmid: 3789282
references.citation: Surg Clin North Am. 1992 Dec;72(6):1429-47
references.pmid: 1440164
references.citation: Int J Pediatr Otorhinolaryngol. 1998 Jun 1;44(1):47-50
references.pmid: 9720680
references.citation: Laryngoscope. 2010 Sep;120(9):1773-8
references.pmid: 20715087
references.citation: Ear Nose Throat J. 1998 Aug;77(8):642-4, 646-7, 651
references.pmid: 9745181
references.citation: Arch Otolaryngol Head Neck Surg. 1987 Apr;113(4):418-20
references.pmid: 3814396
references.citation: Head Neck Surg. 1982 Nov-Dec;5(2):134-46
references.pmid: 7169333