Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar;131(3):553-558.
doi: 10.1002/lary.28887. Epub 2020 Jul 15.

The Relevance of and Surgical Approach to the Suprahyoid Region in Thyroglossal Duct Surgery

Jeffrey A Koempel  1 , Jennifer Brooks  2 , Mikel H Snow  3 , Beth Osterbauer  1 , Erick Garcia  4 , Ramzi Bawab  5 , Jared Shows  5 , David Parham  5
Affiliations

The Relevance of and Surgical Approach to the Suprahyoid Region in Thyroglossal Duct Surgery

Jeffrey A Koempel et al. Laryngoscope. 2021 Mar.

Abstract

Objectives: Persistent or recurrent disease following excision of a thyroglossal duct cyst/sinus (TGDC) is often found in the suprahyoid region. Cadaver dissections were performed to identify and name important surgical landmarks in the suprahyoid area; a histopathologic analysis of surgical specimens was completed to determine the incidence and extent of microscopic disease; and clinical outcomes were compared to determine the efficacy of a specific anatomic dissection.

Study design: Retrospective case series.

Methods: Standardized dissections of four adult cadavers were performed. Consecutive surgical specimens were examined for evidence of microscopic TDGC disease in the suprahyoid region, measuring the greatest width and length of disease. A retrospective review of all consecutive TGDC procedures was completed.

Results: The important surgical landmarks in the suprahyoid area were identified in all cadavers. Microscopic disease in the suprahyoid area was found in 79% (37 of 47) of surgical specimens. The mean greatest length and width of microscopic disease was 12.4 mm and 1.4 mm, respectively. Following identification of these landmarks, the incidence of recurrent or persistent disease decreased (P = .02) from 5% (8 of 159) to 0% (0 of 112).

Conclusion: The majority of pediatric patients with a TGDC will have microscopic disease in the suprahyoid area. The surgical landmark of the fascial plane between the geniohyoid and genioglossus muscles demarcates the anterior and lateral borders of resection in the suprahyoid area. This approach can be used as a reliable and easily reproducible technique in TGDC surgery to increase confidence of achieving complete removal of disease in the suprahyoid area, avoiding persistent or recurrent disease and a revision procedure.

Level of evidence: 4 Laryngoscope, 131:553-558, 2021.

Keywords: Sistrunk procedure; recurrent thyroglossal duct cyst; revision Sistrunk procedure; suprahyoid area; thyroglossal duct cyst/sinus.

PubMed Disclaimer

References

BIBLIOGRAPHY

    1. Papsin B, Friedberg J. Congenital masses in the neck. In: Wetmore RF, Muntz HR, TJ MG, et al., eds. Pediatric Otolaryngology: Principles and Practice Pathways. New York, NY: Thieme; 2000:961.
    1. Galluzzi F, Pignataro L, Gaini RM, Hartley B, Garavello W. Risk of recurrence in children operated for thyroglossal duct cysts: a systematic review. J Pediatr Surg 2013;48:222-227.
    1. Pastore V, Bartoli F. “Extended” Sistrunk procedure in the treatment of recurrent thyroglossal duct cysts: a 10-year experience. Int J Pediatr Otorhinolaryngol 2014;78:1534-1536.
    1. Soucy P, Penning J. The clinical relevance of certain observations on the histology of the thyroglossal tract. J Pediatr Surg 1984;19:506-509.
    1. Maddalozzo J, Alderfer J, Modi V. Posterior hyoid space as related to excision of the thyroglossal duct cyst. Laryngoscope 2010;120:1773-1778.

LinkOut - more resources