Thyroglossal Duct Anomalies: A Retrospective Analysis

Thyroglossal duct anomalies (TDA) must be considered in the diagnosis of head and neck masses in children as well as adults. TDA are the commonest cause of congenital cysts and sinus in neck in paediatric population. In authors experience 37 patients were diagnosed and treated for TGA. The objective of this study is to analyse clinical presentation pattern and final outcome of Sistrunk procedure in these patients. In our series TDA affected more male (72.98%) in comparison to females (27.02%) this ratio was much higher in comparison to previous reports. Site of lesion was as expected, more common in infrahyoid location (85%) and midline (94.59%). Classical presentation of asymptomatic lump was seen in only 35% of patients. Surprisingly incidence of sinuses (54%) was much higher than cysts (46%).This probably was result of misdiagnoses and inadequate surgical intervention at local level. No patient presented with complications like dyspnoea or dysphagia. In all patents, ultrasound (USG) neck and thyroid function test were standard protocol for confirmation of clinical diagnosis as well as exclusion of the possibility of ectopic thyroid tissue. In one patient of cystic swelling with mixed cystic solid consistency, FNAC excluded the suspicion of malignancy. In 2 cases of multiple recurrences MRI was done for evaluation of sinus tract. In all patients Sistrunk procedure was done with no recurrence till 2 years of follow up. In cases of multiple recurrences wide local excision of soft tissue in submental triangle was done in addition to Sistrunk procedure with favourable outcome. We feel that through understanding of embryology of TDA and meticulous dissection along anatomical planes is essential for adequate treatment and prevention of recurrence in these patients.