Outcomes of Modified Sistrunk Procedure for Pediatric Thyroglossal Duct Cyst Removal: Systematic Review and Meta-Analysis.

Abstract

Objective: This meta-analysis aims to evaluate the safety and efficacy of the modified Sistrunk procedure in pediatric patients with thyroglossal duct cyst.

Data sources: A comprehensive literature search was conducted across Ovid MEDLINE, Embase, CINAHL and The Cochrane Library, from inception to April 16, 2025.

Review methods: Screening and selection followed PRISMA guidelines, and the review protocol was prospectively registered with PROSPERO (CRD420251022683). Eligible studies included pediatric patients undergoing the modified Sistrunk procedure for thyroglossal duct cysts. Data extraction was performed independently by reviewers, and study quality was assessed using standardized appraisal tools. Pooled estimates for recurrence, complications, infection, postoperative drainage and operative time were calculated using a random-effects meta-analysis model to account for between-study variability.

Results: Of 999 studies screened, 5 studies met the eligibility criteria, with a total of 937 pediatric patients with thyroglossal duct cyst undergoing modified Sistrunk procedure. The pooled recurrence rate was 4% (95% CI: 0.02, 0.07; I ² = 59%), and the complication rate was 12% (95% CI: 0.01, 0.32; I ² = 97%). The pooled infection rate was 6% (95% CI: 0.02, 0.10; I ² = 84%), whereas the postoperative drainage rate was 5% (95% CI: 0.00, 0.14; I ² = 91%), and operative time was 49.0 minutes (95% CI: 33.6 min, 64.5 min; I ² = 99%).

Conclusions: The modified Sistrunk procedure appears to be a safe approach for the management of thyroglossal duct cysts for pediatric patients. However, heterogeneity in technique highlights the need for standardized definitions and high-quality studies to inform clinical guideline development.