Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
The thyroglossal duct cyst results from a failure in obliterating the embryonic duct produced during thyroid migration and it represents the most common type of developmental cyst encountered in the neck region. Ectopic thyroid tissue neoplasia is rare, and it is even rarer when associated with the thyroglossal duct cyst.
OBJECTIVE:
To study the clinical behavior, distribution and treatment of thyroglossal cyst and fistula.
MATERIALS AND METHODS:
A prospective study carried out during the period 2002-2011, in the otolaryngology departments of Al Diwaniyah Teaching Hospital and Gazi Hariri Hospital, 72 patients suffering from thyroglossal cyst and sinuses were diagnosed and treated (60 cysts and 12 sinuses). The data were collected on the basis of history, physical examination, investigations, management and follow up.
RESULTS:
A seventy two patients complaining from thyroglossal duct cyst and sinuses were diagnosed and treated. 45 male (62.5%) and 27 female (37.5%). The commonest age of presentation is the second decade, 33 patients (46%). The most common clinical presentation of thyroglossal duct cyst is a midline neck mass and a midline anterior neck discharging opening in cases of thyroglossal sinuses. The thyrohyoid region is the most common location of both thyroglossal cysts and sinuses. The histological diagnosis in all the cases was benign (100%). All the patients were managed by Sistrunk s operation. The recurrence was seen in only one patient (1.3%). The incidence of carcinoma in the cysts or sinuses was 0.0%.
CONCLUSION :
Thyroglossal cysts and sinuses are quite prevalent. Thyroglossal cyst usually appears as a midline swelling in the prehyoid region of the neck. The etiology of thyroglossal sinuses in this study is mostly iatrogenic which means more awareness is required about diagnosis and proper management of thyroglossal cyst. The standard surgical approach is Sistrunk operation for both thyroglossal cyst and sinuses with low recurrence rate.