Efficacy and safety of ethanol ablation for thyroglossal duct cysts

Abstract

Background and purpose: TGDC is a common congenital neck lesion, which has been treated by surgery. Although surgery is curative, it has drawbacks such as scars and surgical morbidity. Therefore, we applied EA as an alternative treatment technique. The purpose of this study was the evaluation of the efficacy and safety of EA for TGDC.

Materials and methods: Between May 2005 and July 2008, we performed EA in 11 patients with TGDC who refused surgery. All patients were confirmed as having benign lesions before treatment. US-guided aspiration of the cystic fluid was followed by injection of absolute ethanol (99%). The injected volume of ethanol was 50%-80% of the volume of fluid aspirated. We evaluated the therapeutic outcome, including volume reduction of the TGDC, improvement of cosmetic problems and symptoms, and complications.

Results: The initial volume of the cysts ranged from 0.67 to 29.39 mL (mean, 6.0 mL). The procedure was performed in 1-3 sessions (mean, 1.4 sessions). Follow-up US was performed in 10 patients from 3 to 29 months (mean, 13.6 months). The mean volume of the cyst was 6.0 ± 8.4 mL, and volume reduction was 43.9%-100% (mean, 81.3%, P = .005) at last follow-up. Therapeutic success (volume reduction of >50%) was observed in 8 patients (8/10, 80%). Significant improvement of symptom- (P = .005) and cosmetic-grading scores (P = .003) was observed at last follow-up. No significant complications were observed during the procedure or follow-up periods.

Conclusions: EA seems to be an effective and safe treatment method for TGDC.

Fig 1.

A 41-year-old woman (patient 10). Axial (A) and longitudinal (B) sonograms show the TGDC in a suprahyoid location (2.0 × 2.3 × 3.1 cm; volume, 7.46 mL) filled with fluid. Axial (C) and longitudinal (D) sonograms obtained 13 months after EA show marked shrinkage of the TGDC. (0.35 × 0.6 × 0.76 cm; volume, 1.08 mL; volume reduction, 85.5%)

Fig 2.

A 39-year-old woman (patient 11). Axial (A) and longitudinal (B) sonograms show a multiloculated TGDC in an infrahyoid location (1.2 × 2.0 × 2.2; volume, 2.76 mL). Sagittal CT scan (C) shows that the TGDC wraps around the hyoid bone (arrows). Axial (D) and longitudinal (E) sonograms and a sagittal CT scan (F) obtained 11 months after EA. Arrowheads indicate shrinkage of the TGDC (0.66 × 0.85 × 1.18; volume, 0.35 mL; volume reduction, 87.5%).