From the Research
The treatment of choice for a thyroglossal duct cyst is complete surgical excision via the Sistrunk procedure, as it significantly reduces recurrence rates and is considered a safe and effective procedure 1, 2.
Overview of Thyroglossal Duct Cyst Treatment
The Sistrunk procedure involves removing the cyst, the central portion of the hyoid bone, and the tract leading to the base of the tongue. This approach is recommended even for asymptomatic cysts to prevent future infection, potential malignant transformation, and cosmetic concerns.
Key Considerations
- Preoperative evaluation should include thyroid function tests and imaging (ultrasound or CT scan) to confirm the diagnosis and ensure a normal thyroid gland is present.
- Antibiotics may be prescribed before surgery if the cyst is infected, with surgery delayed until the infection resolves.
- The procedure is generally performed as outpatient surgery under general anesthesia, with patients returning home the same day.
- Potential complications include infection, hematoma, seroma, and injury to surrounding structures, but these are uncommon with experienced surgeons.
Recent Evidence
A recent study published in 2021 2 supports the use of the Sistrunk procedure as the baseline of surgical treatment for thyroglossal duct cyst carcinomas, with additional treatments such as thyroidectomy, neck dissection, and adjuvant therapy considered for high-risk lesions.
Conclusion Not Applicable - Direct Answer Only
The Sistrunk procedure is the preferred treatment for thyroglossal duct cysts, with a recurrence rate of less than 3% when performed correctly 1. Some key points to consider when performing the Sistrunk procedure include:
- Resection of the body of the hyoid bone
- Removal of the cyst and tract leading to the base of the tongue
- Potential risks for recurrence, such as surgery during the inflammatory phase, cyst rupture during dissection, and technical error during the surgical procedure.