Analysis of the curative effect and risk factors for recurrence of modified Sistrunk procedure on thyroglossal duct cyst in children

Abstract

Abstract Objectives The present study aimed to retrospectively summarize the optimization experience of the modified Sistrunk (mSis) procedure, analyze the curative efficacy of this procedure in the treatment of children with thyroglossal duct cyst (TGDC), and investigate the related risk factors for recurrence. Methods A retrospective analysis was conducted on children undergoing mSis procedure from March 2012–December 2021. Based on our practical experience, the mSis procedure has been optimized in the following details: the resection at the cartilaginous joint of hyoid bone, core out to the foramen cecum, and the resection and ligation techniques of the fistula near the foramen cecum. Medical history, physical examination characteristics, ultrasound characteristics, and prognosis were evaluated by regression analysis. Results Of the 391 children with TGDC, the recurrence rate was 2.30% and the recurrence time ranged from 0.5–34 (average, 7.2) months after the procedure. During the follow-up, 10 children had local wound infection but no recurrence and none had other complications. In the Poisson regression model, the p-values of the three factors of clearness of lesion boundary, surgical history, and lesion diameter were < 0.05 and the relative risk (RR) values corresponding to the above three risk factors, such as Exp (B), were 27.918, 10.054, and 6.606, respectively. Conclusion The present study made optimizations based on the previous mSis procedure and integrated the complete resection and less injury. Thus, the procedure was safe and effective with fewer complications and a low recurrence rate. In addition, the indistinct lesion boundary, surgical history, and large lesion diameter were independent risk factors for disease recurrence. Level of Evidence: IV