The Effect of Complete Excision of the Hyoid Bone Corpus from the Cartilage Margins on the Success of Sistrunk Procedure in Children: The Preliminary Results

Abstract

Objective: To analyze the effects of the hyoid bone excision magnitude and Z-shaped extra stitches, putting in the base of the mouth on the success of the surgical treatment of thyroglossal duct cyst (TGDC). Materials and Methods: A retrospective analysis of 19 patients who underwent Sistrunk procedure between October 2013 and November 2018 was performed, and 16 patients with sufficient data were included in this study. In surgical procedures, we modified the Sistrunk procedure with a broader excision of mid-portion of hyoid bone, and Z-shaped extra stitches were put in the floor of the mouth. The patients were evaluated for age, sex, preoperative examinations, surgical findings, complications, and recurrence. Results: The mean age of the patients was 5.12 years (range, 2 to 9 years), and 11 (69%) were female, and five (31%) were male. Twelve (75%) and three (19%) patients were presented with cyst and fistula formation, respectively. One (6%) patient referred to us as a result of recurrence with her previous sonographic results, which indicated TGDC. Only one patient (6%) experienced disease recurrence, and it was achieved a success rate of 94%. All the patients were followed for a mean of 12.81 (range, 6 to 21 months) months. Conclusion: Extensive removal of the hyoid bone and Z-shaped sutures ligating possible ducts associated with the oral cavity may increase the rate of success in the surgical treatment of TGDC in children. However, this suggestion should be supported by further investigations.

Keywords

• thyroglossal duct cyst
• sistrunk operation
• hyoid cartilage
• recurrence.