THYROGLOSSAL DUCT CYST - OLD AND NEW SURGICAL APPROACH

The thyroglossal duct cyst (TDC) results from a failure in obliterating the embryogenic duct produced during thyroid migration and it represents the most common type of developmental cyst encountered in the neck region. Material and methods: In the First Surgical Clinic from " Sf. Spiridon" County Clinical Emergency Hospital Iasi, Iasi, between 1998 to 2021, 21 patients with thyroglossal duct cyst were diagnosed and treated. All medical records were reviewed. Results: The thyroglossal duct cysts are located as midline cysts of the neck in all cases. The mean age was 39.2 years (13-66 years). The treatment performed was a variant of Sistrunk's procedure in which the thyroglossal tract was excised to a variable extent, with central hyoidectomy. The size of the cyst ranged from 1.2 to 4 cm (mean 2.6 cm). Postoperative course was uneventful in all cases. No recurrence was recorded in this series. We describe a case, a 42 years old women, with asymptomatic mass in the anterior part of the neck found a 6 months before, when the patient was referred us with lithiasic obstructive jaundice (we performed ERCP + laparoscopic cholecystectomy). The treatment performed was a variant of Sistrunk's procedure in which the thyroglossal tract was excised by minimally invasive video-assisted approach, variation of Miccoli's technique. Postoperative course was uneventful. The follow-up 1 and 2 years no recorded recurrence and thyroid scintigraphy was normal. Conclusions: The standard surgical approach to TDC is Sistrunk's operation with low recurrence rates. Although the results and the operative time are the same as in traditional surgery, minimally invasive video-assisted approach has better cosmetic result and a less painful course.