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Preoperative Sonography in Presumed Thyroglossal Duct Cysts
Pankaj Gupta, MD;
John Maddalozzo, MD
Arch Otolaryngol Head Neck Surg. 2001;127:200-202.
Objective To determine the utility of ultrasonography as a sole diagnostic study
in the preoperative preparation of patients with presumed thyroglossal duct
cysts.
Design Retrospective chart review.
Settings Children's Memorial Hospital, Chicago, Ill.
Patients Forty-five pediatric patients with midline masses.
Main Outcome Measure Accuracy in the determination of a normally positioned thyroid gland
excluding the presence of a solitary ectopic thyroid gland.
Results A retrospective chart review was performed at our institution for the
period February 1990 to January 1996. A total of 45 patients with midline
masses were identified, 39 of whom had undergone preoperative ultrasonography
as their sole diagnostic imaging study. In all 39 patients, both a cyst and
a normal thyroid gland were identified. All 39 patients underwent the standard
Sistrunk procedure. Thirty-seven patients had pathologically confirmed thyroglossal
duct cysts. The remaining 2 had dermoid cysts. There were no cases of postoperative
hypothyroidism.
Conclusions The incidence of ectopic thyroid in the diagnosis of thyroglossal duct
cysts has been reported to be as high as 1% to 2%. In our surgical and clinical
experience, the actual incidence of solitary ectopic thyroid tissue is substantially
lower. Nevertheless, to prevent the inadvertent removal of the only functioning
thyroid tissue, with resultant postoperative hypothyroidism and possible medicolegal
consequences, we advocate the routine preoperative identification of normal
thyroid gland. We recommend ultrasound as an accurate, cost-effective, noninvasive
imaging modality in the preoperative evaluation of all patients with neck
masses suspicious for thyroglossal duct cyst. Also, it does not require sedation.
From the Department of Otolaryngology–Head and Neck Surgery,
Northwestern University Medical School, Northwestern University (Drs Gupta
and Maddalozzo), and the Department of Pediatric Otolaryngology and Communicative
Disorders, Children's Memorial Hospital (Dr Maddalozzo), Chicago, Ill. Dr
Gupta is now with the Department of Otolaryngology–Head and Neck Surgery,
Dean Medical Center, Madison, Wis.
Corresponding author and reprints: John Maddalozzo, MD, Department
of Pediatric Otolaryngology and Communicative Disorders, Children's Memorial
Hospital, 2300 Children's Plaza, Chicago, IL 60614.
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