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PubMedDate not supplied

Thyroglossal duct remnant: seven years analysis.

To analyze the clinico-pathological findings and surgical outcome in a patient population that underwent surgical procedures for the excision of the thyroglossal duct remnant (TGDR) i.e., cyst or sinus. A retrospective descriptive study was performed to include all patients of thyroglossal duct remnant who underwent the surgical procedures at National Academy of Medical Sciences, Nepal form April, 1998 to April, 2005 A.D. Age, sex, position of the thyroglossal duct remnant, histopathology of the lesion, type of surgery and its outcome with particular emphasis on recurrence were noted. All data were obtained from the patients' admission charts. Thirty clinically diagnosed thyroglossal duct remnant were enrolled in this study. Twenty-seven were histopathologically confirmed thyroglossal duct remnant and remaining three patients were dermoid cyst and tuberculous lymphadenopathy and were excluded from the study. The sex distribution was almost equal. The commonest age group affected by TGDR was less than twenty years (70.38 %) and commonest site was midline subhyoid (85.19 %). The post-operative complication rate of thyroglossal duct remnant was 18.51 % in the present study. Thyroglossal duct remnant is the commonest congenital cervical lesion in the pediatric population. Other clinical conditions of neck can masquerade as thyroglossal duct remnant so histopathological confirmation is mandatory. Sistrunk operation is the standard treatment to minimize recurrence.

Adolescent↗
PubMed2003

Additional phenotypic abnormalities with presence of cysts within the empty thyroid area in patients with congenital hypothyroidism with thyroid dysgenesis.

Congenital hypothyroidism (CH) is most frequently caused by thyroid developmental abnormalities, and it has recently been shown to have a familial component with members affected by either CH or asymptomatic thyroid developmental abnormalities. The pathogenesis of the disease is unknown, but it seems possible that a common genetic mechanism underlies these heterogeneous phenotypic expressions. Associations among these anomalies in the same individuals have occasionally been described. The aim of this study was to investigate whether cysts of the thyroglossal duct could be shown by ultrasonography in patients with CH caused by thyroid dysgenesis. Children with CH (n = 57) who were diagnosed by newborn TSH screening were prospectively evaluated by ultrasonography at the age of 10.5 +/- 4.5 yr. The etiology of CH (ectopic thyroid tissue, n = 42; athyreosis, n = 15) was established before treatment initiation on the basis of thyroid radioiodine scanning and the absence of any thyroid tissue in the normal location confirmed by ultrasonography. Cysts were found in 39 patients (68% of cases) with either ectopic thyroid tissue (n = 29) or athyreosis (n = 10). All cysts were located in the empty thyroid area in the left (57%) or right (43%) side and were mostly closer to the midline. Patients had either a single cyst (n = 16 patients) or multiple cysts (n = 23 patients). The cysts were bilateral in 17 of the 39 patients. Most of them were vertically oval or round, with a size ranging in diameter from 2-21 mm (mean, 3.5 +/- 2). In conclusion, the presence of cysts within the empty thyroid area in 68% of patients with CH due to thyroid dysgenesis is a novel observation that is part of the developmental anomaly of this disease. Several explanations can be put forward to explain the presence of these cysts. They might be due to the persistence of the ultimobranchial bodies as a cystic structure or part of the thyroid-forming material, which may migrate along the normal pathway of the usual course of the thyroglossal duct, giving rise to cell residues within the empty thyroid area.

Adolescent↗
PubMed1988

Operative treatment of median cervical cysts.

Median cervical cysts are congenital anomalies arising from remaining thyroglossal duct epithelium. A major problem in the surgical treatment of these cysts is the high frequency of recurrence. Embryonic considerations indicate an important causal role for the hyoid bone in these recurrences. We studied the relationship between operative techniques and the number of recurrences in 36 patients treated in our hospital. Fourteen patients sent from other hospitals had a recurrent fistula; in thirteen cases the hyoid bone was still in place. All patients who had the central part of the hyoid bone excised were cured. In 14 patients without adequate excisions of the hyoid bone we found four recurrences. To prevent recurrence a total excision of thyroglossal duct epithelium is necessary.

Adolescent↗
PubMedDate not supplied

Ultrasound characteristics of thyroglossal duct anomalies.

The purpose of this study was to determine the value of ultrasound examination in the diagnosis of thyroglossal duct anomalies. The ultrasound and palpation findings in 24 patients with a thyroglossal duct anomaly were reviewed. Cysts, tracts and ectopic thyroid tissue appeared to produce a characteristic ultrasound pattern in most cases. This study includes 5 patients with non-symptomatic lesions which were detected at ultrasound examination. The necessity of performing a radionuclide scan prior to surgery for a thyroglossal duct anomaly is reconsidered in view of the diagnostic power of ultrasound in thyroid disease.

Biopsy, Needle↗
PubMed1976

[Management of median cysts and fistulae (author's transl)].

The total extirpation of thyroglossal duct remnants with resection of the mid hyoid bone is reported as the only method for successful surgical therapy. Convoluted ducts of cysts and fistulae must be dissected to the base of the tongue and excised. As our cases demonstrate, recurrences will be avoided and revision surgery, when required, will be most successful.

Branchioma↗
PubMed1986

Hypertrophied thyroid tissue in a thyroglossal duct remnant.

A 37-year-old woman was evaluated for a neck mass. This was located in the midline below the hyoid bone. Thirty-three years had elapsed since she had undergone subtotal thyroidectomy for hyperthyroidism. Eight years prior to examination, the patient had discontinued her thyroid maintenance medications. She had discovered the mass eight months prior to examination. Thyroid scan (Fig. 1) showed intense uptake in the mass. At operation the mass was attached to the midportion of the hyoid bone by a small fibrous band, as is usual in a thyroglossal duct remnant. Biopsy results showed diffuse thyroid hyperplasia. Thyroglossal duct remnants are known to harbor cysts or thyroid carcinoma, but growths of compensatory hyperplastic tissue are unusual.

Adult↗
PubMed2005

Cervical bronchogenic cysts in head and neck region.

Congenital cysts of the neck are not uncommon. Most of these are thyroglossal, branchial cleft and thymic cysts. Bronchogenic cysts are uncommon developmental anomalies of the tracheobronchial tree and rarely occur in the neck. More than 70 cases of bronchogenic cysts in the head and neck region have been reported in the literature. We report three cases presenting with neck swelling in the hyoid region that were diagnosed as bronchogenic cysts based on clinical and histopathological findings.

Bronchogenic Cyst↗
PubMed1980

[Thyroglossal duct fistulae: congenital or iatrogenic? (author's transl)].

Clinical observations demonstrate that thyroglossal fistulae very often arise following surgical interventions. Fistulae especially appeared after incisions, punctures, enucleations or radiation therapy of a median cyst. These types of treatment should be avoided, the radical removal of thyroglossal abnormality being the only rational procedure. General clinical findings are reported in tabulated statements.

Female↗
PubMed1986

Carcinoma of the thyroglossal duct.

Based on the case histories of six patients with carcinoma of the thyroglossal duct, the literature on the origin and treatment of this disease was reviewed. As to the treatment of papillary adenocarcinoma there is some controversy, although in most cases treatment is limited to local excision as described by Sistrunk, provided that tumor growth is restricted to the cyst. The prognosis of this carcinoma seems favorable. Squamous cell carcinoma of the thyroglossal duct is rare; there is no uniform advice as to its treatment, and the prognosis is poor.

Adenocarcinoma, Papillary↗
PubMed1990

Thyroglossal duct and second branchial cleft anomalies in adults.

Definitive treatment is surgical removal of the cyst and any tract, with care taken to preserve vital structures. TDCs and BCCs are congenital cervical lesions that are encountered in adults. Experiences at the Eye and Ear Hospital of Pittsburgh are reviewed. Forty-five patients with TDCs and 59 patients with BCCs were treated between 1983 and 1988. Clinical findings are discussed and principles for diagnosis are detailed.

Adolescent↗
PubMed2001

Lateral cervical bronchogenic cyst: an unusual cause of a lump in the neck.

BACKGROUND: Congenital cysts of the neck in children are not uncommon. Most of these are thyroglossal, branchial cleft, or less commonly, thymic cysts. Bronchial cysts rarely are initially seen as a neck mass. METHODS: Use of an illustrative case of a bronchogenic cyst initially seen as an upper lateral neck mass. CONCLUSIONS: We emphasize that although ectopic bronchogenic cysts are rare lesions of the head and neck, especially in the upper lateral neck, they should be included in the differential diagnosis in the evaluation of congenital neck cysts.

Bronchogenic Cyst↗
PubMed1993

Common congenital anomalies of the neck. Embryology and surgical anatomy.

A good knowledge of embryology and surgical anatomy allows for the anticipation of intraoperative findings, and, hence, for safer and more efficient care of patients with congenital anomalies of the neck. Presumptive thyroglossal anomalies that are at or above the level of the hyoid mandate extra vigilance: the patient may not have sufficient thyroid tissue in the usual thyroid location. The discontinuous character of thyroglossal tracts, related to ontogenesis, ordains dissection to the lingual mucosa. First branchial cleft cysts and fistulas require knowledge of facial nerve anatomy; in some of these cases, the facial nerve is best identified in the temporal bone. Branchial cysts, sinuses, and fistulas only can be assigned to a specific pouch-cleft by their anatomic relations to cervical structures.

Branchial Region↗
PubMed1979

[Results of the surgical treatment of children with residual developmental anomalies of the 1st and 2d branchial clefts and thyroglossal duct].

The purpose of this study was assessment of the results of surgical treatment of children with developmental anomalies derived from the first and second branchial clefts and thyroglossal duct. Normal and abnormal development of branchial arches and clefts, pharyngeal pouches and thyroglossal duct, as well as the anatomy nd topography of the resulting developmental anomalies are discussed. The observed developmental anomalies are classified into: cysts, cysts with sinuses developing as a result of inflammatory processes, puncture, incision, operation, dermal sinuses draining externally, dermal sinuses with external and internal orifices, the latter in the groove of the palatine tonsil or foramen caecum of the tongue, dermal sinus with external orifice and dermal fistula. Methods of diagnostic investigations and surgical treatment are described. The cysts derived from the first and second branchial arches were treated surgically by a transverse incision running across the peak of the bulging cyst. Removal of the cyst was started by dissection of the anterior and lateral surfaces of the wall, and then the posterior wall was dissected free from the deep structures in the neck. In cases of cysts with fistulae or dermal sinuses the operation was preceded by injection of 1% methylene blue into its external orifice. In this way it was possible to stain the walls of the cyst or sinus and to mark its end. The operation was started with elliptical excision of the external orifice of the lesion. In cases of dermal sinuses derived from the first branchial clefts an additional incision was made along the posteroinferior border of attachment of the auricule to the skull. In operations of dermal sinuses derived from the second branchial cleft after dissection of the wall at a distance of several centimeters a second incision was made transversely for easier dissection of the sinus wall lying in deeper parts of the neck. Removal of the cysts and sinuses derived from the thyroglossal duct required always resection of the middle part of the body of the hyoid bone. Upward elevation of the cut hyoid bone body visualized the upper part of the thyroglossal duct up to its end in the lingual foramen caecum, and made possible removal of this part. The cut hyoid bone body was left divided. In the years 1953-1976 56 children were treated surgically for these developmental anomalies. The material comprised 33 girls and 23 boys. Three groups of patients were isolated. Most children were operated upon between the 5th and the 9th year of life at the age of 12 years.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1990

[The Sistrunk median cervical cyst operation using a cecal foramen pointer].

The cecal foramen pointer was invented for a Sistrunk median cervical cyst operation. The instrument consists of three elements, namely: The cecal foramen holder, the giraffe shaped connector and the pointer needle. First of all, the cecal foramen is held by the holder which is reconstructed from hemostatic forceps. The one end of the connector is joined to the holder's handle. Then the other end of the connector comes along the patient's chin, in front of the neck. The cyst and mid-portion of the hyoid bone are dissected, followed by coring out of the thyroglossal duct toward the cecal foramen. In the coring out process, the pointer needle is pierced through the tunnel of the connector's opposite end, so that the needle top reaches to the bottom of operative wound. Then the needle shows exactly the direction to the cecal foramen and the distance from the bottom of the wound to the cecal foramen. By using this instrument the operation was successfully performed for a case of a recurrent median cervical cyst with a complete fistula to the cecal foramen.

Humans↗
PubMed1989

Recurrent parathyroid cystic disease.

Cystic masses of the neck may represent thyroid, parathyroid, thyroglossal duct or branchial cleft cysts. Analysis of the cyst fluid may establish the etiology. Elevated levels of parathyroid hormone can be found in parathyroid cysts without concomitant hyperparathyroidism. A high concentration of cholesterol without the finding of thyroglobulin or parathyroid hormone in the fluid aspirated from a lateral neck mass suggests a branchial cleft cyst.

Adult↗
PubMed1995

[Mento-sternal fistulae. Review of the literature. Apropos of 4 cases].

Mentosternal fistula is a very rare entity. 70 cases had been reported in the French literature up until 1984. Mentosternal fistula is very different from cyst and fistula of the thyroglossal duct. There is no consensus concerning both pathologically and embryologically, the ethiopathogenesis of mentosternal fistula, but the most widely accepted embryological theory seems to be inclusion of ecto or endodemic material at the time of fusion of the branchial tissues in the cervical midline. Clinical features, in the complete form, are very typical and must be distinguished from thyroglossal duct anomalies. No thyroid exploration is required before the surgical procedure which must be simple and complete.

Child↗
PubMed1985

Thyroglossal tract anomalies.

Thyroglossal tract anomalies present most frequently before the second decade of life. Investigations should include ultrasound and thyroid isotope scan to demonstrate the presence of other functioning thyroid tissue prior to excision. Cysts demonstrating echogenic material centrally should be considered to be inflamed and surgical exploration carried out under antibiotic cover to minimize postoperative infection. Total excision of the thyroglossal tract anomaly must include the body of the hyoid bone to prevent recurrence and reduce the risk of further symptoms.

Adolescent↗
PubMed1979

Clinicopathological studies on thyroglossal duct remnant.

The clinicopathological findings in 48 cases underwent complete surgical excision of epithelial tissue of the thyoglossal duct remnants were reviewed. Simple incision of the cyst does not seem to have any therapeutic value and would be followed frequently by recurrence. The widely used Sistrunk procedure 2,6 surgical excision of the central portion of the hyoid bone together with fibrous tract extending to the base of tongue, seems to be warranted in some cases so long as complete eradication of the epithelial tissue can be made.

Adolescent↗