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Preoperative Evaluation and Management

Diana Radkowski, MD; James Arnold, MD; Gerald B. Healy, MD; Trevor McGill, MD; S. T. Treves, MD; Harriet Paltiel, MD; Ellen M. Friedman, MD

Arch Otolaryngol Head Neck Surg. 1991;117(12):1378-1381.

Abstract
• Midline cervical cysts arising from the thyroglossal duct are one of the most common causes of anterior neck swelling in children. The potential for confusion between the thyroglossal duct cyst and the ectopic thyroid gland is well documented and may result in serious complications. A retrospective chart analysis was therefore undertaken to determine the relative importance of clinical evaluation, thyroid function testing, and radioisotope scanning in distinguishing these two entities preoperatively. A combined study was carried out by The Children's Hospital, Boston, Mass, and Rainbow Babies Hospital, Cleveland, Ohio. The hospital records, including nuclear scans, were reviewed. A total of 229 patients were taken to the operating room between January 1, 1978, and December 31, 1987. Nuclear scanning was performed in 30% of these patients. This subgroup of patients forms the basis for our guidelines of preoperative assessment. The absolute need for a preoperative scan is reexamined.

(Arch Otolaryngol Head Neck Surg. 1991;117:1378-1381)

Author Affiliations
From the Departments of Otolaryngology and Communicative Disorders (Drs Radkowski, Healy, McGill, and Friedman) and Radiology, Division of Nuclear Medicine (Drs Treves and Paltiel), The Children's Hospital, Boston, Mass, and the Department of Otolaryngology, Rainbow Babies and Children's Hospital, Cleveland, Ohio (Dr Arnold). Presented at the American Society of Pediatric Otolaryngology Annual Meeting, Toronto, Ontario, May 12, 1990.

Footnotes
Accepted for publication May 9, 1991.

Reprints to the Department of Otolaryngology, The Children's Hospital, 300 Longwood Ave, Boston, MA 02115 (Dr Radkowski).

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