Our Summary

This research paper talks about a better way to treat thyroglossal duct cysts (TGDC), which are benign, or noncancerous, lumps that form in the neck. The traditional way to treat these cysts is called the Sistrunk procedure, which involves removing the cyst, part of a bone in the neck, and the tract leading to a small opening at the base of the tongue.

Recently, endoscopic methods (using a small camera and tools inserted through a tiny incision) have become more popular than traditional open surgery for treating these cysts and other noncancerous thyroid conditions. This paper argues that using an endoscopic Sistrunk procedure, but doing it through two small incisions near the armpit and breast, is an even better method. The authors say this method is safe, effective for treating TGDC, and provides excellent cosmetic results because it leaves smaller scars.

FAQs

  1. What does the Sistrunk procedure for thyroglossal duct cyst removal involve?
  2. How does the endoscopic approach to thyroglossal duct cyst removal compare to traditional approaches?
  3. Why is the endoscopic Sistrunk procedure using bilateral axillo-breast approach considered a better alternative for treating thyroglossal duct cysts?

Doctor’s Tip

A doctor might advise a patient undergoing thyroglossal duct cyst removal to follow post-operative care instructions carefully, including keeping the surgical site clean and dry, avoiding strenuous activities, and taking prescribed pain medication as needed. It is important to attend follow-up appointments to monitor healing progress and address any concerns promptly.

Suitable For

Patients who are typically recommended for thyroglossal duct cyst removal include those who have symptomatic cysts, recurrent infections, or cosmetic concerns. The Sistrunk procedure is commonly recommended for these patients, as it involves complete removal of the cyst, middle portion of the hyoid bone, and the tract towards the foramen caecum. Endoscopic approaches have been shown to be more effective and provide better cosmetic results compared to traditional open approaches. The endoscopic Sistrunk procedure using a bilateral axillo-breast approach is a safe and effective alternative for the treatment of thyroglossal duct cysts.

Timeline

Before Thyroglossal Duct Cyst Removal:

  • Patient may experience a painless lump in the neck, typically located just below the hyoid bone
  • Patient may have recurrent infections or drainage from the cyst
  • Patient may undergo imaging tests such as ultrasound or CT scan to confirm the presence of the cyst
  • Surgeon may recommend removal of the cyst if it is causing symptoms or complications

After Thyroglossal Duct Cyst Removal:

  • Patient undergoes endoscopic Sistrunk procedure using bilateral axillo-breast approach
  • Surgery involves removal of the cyst, middle portion of the hyoid bone, and the tract towards the foramen caecum
  • Patient may experience some pain and discomfort after surgery, which can be managed with pain medication
  • Patient is typically discharged home the same day or the day after surgery
  • Patient may have a follow-up appointment with the surgeon to ensure proper healing and monitor for any complications
  • Patients typically experience excellent cosmetic results with the endoscopic approach, as it leaves minimal scarring compared to traditional open approaches.

What to Ask Your Doctor

  1. What is the reason for recommending removal of the thyroglossal duct cyst?
  2. What are the potential risks and complications associated with the Sistrunk procedure?
  3. How long will the recovery process take after the surgery?
  4. Will there be any restrictions on activities or diet following the procedure?
  5. What type of anesthesia will be used during the surgery?
  6. How often will follow-up appointments be needed after the procedure?
  7. Are there any alternative treatment options for thyroglossal duct cyst removal?
  8. What experience do you have with performing the Sistrunk procedure?
  9. What can I expect in terms of scarring and cosmetic results after the surgery?
  10. Are there any specific post-operative care instructions that I should be aware of?

Reference

Authors: Bhandarwar AH, Balamurugan G, Jadhav S, Tandur A, Jagdale S. Journal: J Minim Access Surg. 2023 Apr-Jun;19(2):329-331. doi: 10.4103/jmas.jmas_64_22. PMID: 37056095