Brett A Campbell, Zachary Kelly, Hae-Young Kim, Michael Joseph Cunningham, Sukgi S Choi
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The secondary outcomes were the factors associated with Sistrunk procedure complications.</p><p><strong>Results: </strong>A total of 357 patients underwent a Sistrunk procedure for TGDC at a mean age of 5.75 years and an average duration of follow-up of 26.5 months. Age, gender, race, cutaneous tracts, tongue base findings, pre-operative infection, number of pre-operative infections, incision and drainage, needle aspiration, placement of a post-operative drain, and the type of drain placed were unassociated with recurrence. The two factors associated with recurrence were postoperative infection (adjusted OR = 11.98 [95% CI: 3.38, 42.49], p = < 0.001) and postoperative seroma (adjusted OR = 5.03 [95% CI: 1.17, 21.62], p = -0.030). Male sex was significantly associated with postoperative complications (adjusted OR = 3.26 [95% CI: 1.55, 6.89], p = 0.002).</p><p><strong>Conclusion: </strong>Recurrence of TGDC after a Sistrunk procedure is an ongoing challenge that occurs in approximately 5% of cases. Recurrence is likely due to two factors: inadequate surgical technique and (or) histological factors like remnant arborizing microscopic ductules. Postoperative infection and seroma do not cause recurrence but may be predictors of residual disease due to one of these two factors and warrant closer surveillance.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictors of Thyroglossal Duct Cyst Recurrence and Complications Following Sistrunk Procedure.\",\"authors\":\"Brett A Campbell, Zachary Kelly, Hae-Young Kim, Michael Joseph Cunningham, Sukgi S Choi\",\"doi\":\"10.1002/lary.32082\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Recurrence is the primary complication of the Sistrunk procedure performed for the resection of thyroglossal duct cysts (TGDC). We aim to more confidently identify patients who may be predisposed to recurrence or other postoperative complications based on their clinical presentation and (or) perioperative course.</p><p><strong>Methods: </strong>Our institution's electronic medical record was queried over a 23-year period (2000-2023) for patients with TGDC who underwent a Sistrunk procedure. Demographics, clinical presentation, and outcomes data were collected and analyzed. The primary outcome was the factors associated with postoperative TGDC recurrence. The secondary outcomes were the factors associated with Sistrunk procedure complications.</p><p><strong>Results: </strong>A total of 357 patients underwent a Sistrunk procedure for TGDC at a mean age of 5.75 years and an average duration of follow-up of 26.5 months. Age, gender, race, cutaneous tracts, tongue base findings, pre-operative infection, number of pre-operative infections, incision and drainage, needle aspiration, placement of a post-operative drain, and the type of drain placed were unassociated with recurrence. The two factors associated with recurrence were postoperative infection (adjusted OR = 11.98 [95% CI: 3.38, 42.49], p = < 0.001) and postoperative seroma (adjusted OR = 5.03 [95% CI: 1.17, 21.62], p = -0.030). Male sex was significantly associated with postoperative complications (adjusted OR = 3.26 [95% CI: 1.55, 6.89], p = 0.002).</p><p><strong>Conclusion: </strong>Recurrence of TGDC after a Sistrunk procedure is an ongoing challenge that occurs in approximately 5% of cases. Recurrence is likely due to two factors: inadequate surgical technique and (or) histological factors like remnant arborizing microscopic ductules. Postoperative infection and seroma do not cause recurrence but may be predictors of residual disease due to one of these two factors and warrant closer surveillance.</p><p><strong>Level of evidence: 3: </strong></p>\",\"PeriodicalId\":49921,\"journal\":{\"name\":\"Laryngoscope\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-02-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Laryngoscope\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/lary.32082\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/lary.32082","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
摘要
目的：复发是Sistrunk手术切除甲状舌管囊肿（TGDC）的主要并发症。我们的目标是根据患者的临床表现和（或）围手术期过程，更自信地识别可能易复发或其他术后并发症的患者。方法：查询我院23年（2000-2023年）期间接受Sistrunk手术的TGDC患者的电子病历。收集和分析人口统计学、临床表现和结局数据。主要结局是与术后TGDC复发相关的因素。次要结果是与Sistrunk手术并发症相关的因素。结果：共有357例患者接受了Sistrunk手术治疗TGDC，平均年龄5.75岁，平均随访时间26.5个月。年龄、性别、种族、皮肤束、舌底表现、术前感染、术前感染次数、切口和引流、吸针、术后引流管的放置和引流管的类型与复发无关。与复发相关的两个因素是术后感染（调整后OR = 11.98 [95% CI: 3.38, 42.49]）， p =结论：Sistrunk手术后TGDC复发是一个持续的挑战，发生在大约5%的病例中。复发可能是由于两个因素：不适当的手术技术和（或）组织学因素，如残余的树枝状显微小管。术后感染和血肿不会引起复发，但由于这两个因素之一，可能是残留疾病的预测因素，需要更密切的监测。证据等级：3；
Predictors of Thyroglossal Duct Cyst Recurrence and Complications Following Sistrunk Procedure.
Objective: Recurrence is the primary complication of the Sistrunk procedure performed for the resection of thyroglossal duct cysts (TGDC). We aim to more confidently identify patients who may be predisposed to recurrence or other postoperative complications based on their clinical presentation and (or) perioperative course.
Methods: Our institution's electronic medical record was queried over a 23-year period (2000-2023) for patients with TGDC who underwent a Sistrunk procedure. Demographics, clinical presentation, and outcomes data were collected and analyzed. The primary outcome was the factors associated with postoperative TGDC recurrence. The secondary outcomes were the factors associated with Sistrunk procedure complications.
Results: A total of 357 patients underwent a Sistrunk procedure for TGDC at a mean age of 5.75 years and an average duration of follow-up of 26.5 months. Age, gender, race, cutaneous tracts, tongue base findings, pre-operative infection, number of pre-operative infections, incision and drainage, needle aspiration, placement of a post-operative drain, and the type of drain placed were unassociated with recurrence. The two factors associated with recurrence were postoperative infection (adjusted OR = 11.98 [95% CI: 3.38, 42.49], p = < 0.001) and postoperative seroma (adjusted OR = 5.03 [95% CI: 1.17, 21.62], p = -0.030). Male sex was significantly associated with postoperative complications (adjusted OR = 3.26 [95% CI: 1.55, 6.89], p = 0.002).
Conclusion: Recurrence of TGDC after a Sistrunk procedure is an ongoing challenge that occurs in approximately 5% of cases. Recurrence is likely due to two factors: inadequate surgical technique and (or) histological factors like remnant arborizing microscopic ductules. Postoperative infection and seroma do not cause recurrence but may be predictors of residual disease due to one of these two factors and warrant closer surveillance.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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