The Evolving Concepts in Treating Thyroglossal Duct Cyst

Yu-Hsuan Lin ； Jenn-Ren Hsiao

《International Journal of Head and Neck Science》 1卷4期 (2017/12) Pp. 231-234

https://doi.org/10.6696/IJHNS.2017.0104.04

摘要

The standard treatment for thyroglossal duct cyst (TGDC) is Sistrunk operation, which consists of cystectomy, central hyoid bone segment resection and removal of a tissue core from hyoid to foramen cecum. However, up to 15.8% of patients may experience a failed operation, indicating existence of technical uncertainties. The central issue of debate is how to remove an ＂adequate＂ tissue core during suprahyoid dissection. Only until recently, a novel surgical technique for routine removal of suprahyoid tissue in a consistent manner has been proposed by Koempel, who reported that no recurrence (0/74) was encountered after adaptation of this technique. On the other hand, there are also emerging data showing that only macroscopic tract encountered during operation at the suprahyoid region needs to be removed. For instance, we have demonstrated that, without routine suprahyoid dissection, an extremely low recurrence rate (0.6%, 1/160) could similarly be achieved. Thus, it is currently considered that routine suprahyoid dissection may not be necessary, or should be conducted in a reliable, consistent manner. Nowadays, under high cosmetic demands, some recent reports have demonstrated the feasibility to safely remove TGDC via retroauricular, axillo-breast/ areolar or transoral approaches using modern robot- and endoscope-assisted techniques. In addition, nonsurgical sclerosing therapy (such as OK-432 or ethanol ablation) has also gained promising results and is considered as a reasonable alternative to surgery in patients with high surgical risk or high cosmetic demands. Taken together, these evolving concepts and new approaches will enable clinicians to conduct an individualized treatment strategy for patients with TGDC.

關鍵字

thyroglossal duct cyst (TDGC) ； Sistrunk operation ； sclerosing therapy