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The high recurrence rate of thyroglossal duct cyst operations is well documented.
Sistrunk's operation is widely accepted as the best procedure to prevent recurrence.
Nonetheless, the optimum depth of core-out is still not well documented. We previously
reported a standard running pattern of the thyroglossal duct in an anatomical reconstruction
study. In more detailed pathological studies, we have tried to determine the optimal
depth for core-out toward foramen cecum and the optimal width of the hyoid bone to
be resected. The following items were clarified. (1) Double the horizontal distance
from midline to the most distant thyroglossal duct in front of the hyoid bone was
2.4 to 9.6 mm. (2) The length of the single duct above the hyoid bone which spreads
into many ductuli as it approaches the foramen cecum was about 3 to 5 mm in 2-to 6-year
old children. (3) The diameter of the thyroglossal duct at the level of the cranial
top of the hyoid bone was 175 to 1,400 μm. Half of the examined cases were less than
500 μm, which may have rendered direct dissection impossible. Based on these studies,
we propose: (1) that a minimum of 10 mm of the hyoid bone should be resected, and
for the sake of safety, more than 15 mm is preferable; and (2) that the depth of the
core-out should be less than 5 mm in young children to avoid the breakdown of the
branched ductuli near the foramen cecum.
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Article info
Footnotes
*Presented at the 24th Annual Meeting of the Pacific Association of Pediatric Surgeons, Hong Kong, May 20–24, 1991.
Identification
Copyright
© 1992 W.B. Saunders Company. All right reserved. Published by Elsevier Inc.
