Beyhan YILMAZ, Engin ŞENGÜL, Aylin GÜL, Mehmet AKDAĞ, Fazıl Emre ÖZKURT, Hakan ÖZKAN, İsmail TOPCU

Tiroglossal Duktus Kisti ve Fistüllerindeki Tecrübelerimiz

Bu çalışmada; tiroglossal duktus kisti nedeniyle opere edilen 45 hastanın, muayene bulguları, klinik özellikleri ve tedavi yöntemlerinin ilgili literatür eşliğinde tartışılması amaçlanmıştır.Kliniğimizde tiroglossal duktus kisti ön tanısı ile opere edilen 45 hastanın başvuru nedeni, fizik muayene bulguları, tanı yöntemleri, tedavi şekli, cerrahi tedavi sonrası nüks ve komplikasyonlar oranları ile pataloji sonuçları kayıtları incelendi. 45 hastanın; 26'sı (% 59) erkek, 19' u (% 41) kadın idi. Yaş aralığı 0-58 yaş olup, yaş ortalaması 12.44 idi. En sık başvuru nedeni; boyun orta hatta ara ara olan akıntı ( %51.1) ve boyunda şişlik şikayeti (%44.4) olup, daha nadir olarak da çene altında şişlik (%6.6), nefes almada güçlük (%4.4) ve göğüste şişlik (%2.2) şikayetlerinden oluşuyordu. Muayenede; 23 hastada fistül, 22 hastada kist formasyonu saptandı. Olguların 37'si primer, 8'i nüks vakadan oluşuyordu.Hastaların hepsine Sistrunk operasyonu uygulanmıştı. Opere edilen hastaların yaklaşık 3 yıllık takiplerinde nüks izlenmedi. Boyun orta hatta şişlik ve akıntı nedeni ile başvuran hastaların ayırıcı tanısında tiroglossal duktus kisti düşünülmelidir. Tiroglossal duktus kistlerinde maligniteye dönüşüm ihtimali olduğundan tedavisi cerrahidir. Cerrahi tedavi olarak rekürrens oranının en az olduğu Sistrunk ameliyatı uygulanır.

Anahtar Kelimeler:

Boyun orta hatta kitle, tiroglossal duktus kisti, sistrunk ameliyatı

Our Experience in the Thyroglossal Duct Cysts and Fistulas

In this study, 45 patients were operated for thyroglossal duct cyst, examination findings, clinical features and treatment options are discussed with the relevant literature.45 patients who operated due to thyroglossal duct cyst were retrospectively analyzed . The presenting symptoms, examination findings, demographic characteristics, imaging techniques, treatment modalities, surgical and histopathologic diagnosis of recurrence after treatment, and complication rates were evaluated.45 patients, 26 (59%) were male, 19(%41) were female. The age range was 0-58 years and the mean age was 12,44. The most common reason for admission, discharge, intermittent midline of the neck (51.1%) and neck swelling (44.4%) and more rarely, swelling under the jaw (6.6%), difficulty breathing (4.4%), and chest swelling (% 2.2) consisted of complaints. Examination, 23 patients with fistulas, cysts formation were detected in 22 patients. 37 cases of primary, recurrent cases consisted of 8. Sistrunk operation were performed in all patients. Average 3-year follow-up, recurrence was observed in patients who underwent surgery.Neck swelling and discharge from the midline thyroglossal duct cyst should be considered in the differential diagnosis of patients presenting with reason. Thyroglossal duct cysts should be treated surgically because of the risk of malignant degeneration. Sistrunk surgery treatment, recurrence rate and a low risk of complications due to at least the gold standard.

Keywords:

Midline neck mass, thyroglossal duct cyst, sistrunk surgery,

PDF

___

1. Al-Khateeb TH, Al Zoubi F. Congenital neck masses: a descriptive retrospective study of 252 cases. J Oral Maxillofac Surg 2007;65:2242-7.
2. Özlügedik, Samet, et al. "Tiroglossal Duktus Kistleri." Journal of Ankara University Faculty of Medicine.2008;61:36-38.
3. Ewing CA, Kornbulut A, Greeley C, Manz H: Presentations of tyroglossal duct cysts in adults. Eur Arch Otorhinolaryngol 1999;256(3):136-138.
4. Mohan PS, Chokshi RA. Th yroglossal duct cysts: a consideration in adults. The American Surgeon 2005;71:508-511.
5. Telander RL, Deane SA. Thyroglossal and branchial cleft cysts and sinuses. Surg Clin North Am 1977; 57: 779-791.
6. Benner KG, Organ CH Jr, Williams GR. Is the treatment for thyroglossal duct cysts too extensive? Am J Surg 1986; 152: 602- 605.
7. Sanders LE, Cady B. Embryology and developmental abnormalities. In: Cady B, Rossi RL, eds. Surgery of the thyroid and parathyroid glands. Philadelphia: W.B. Saunders, 1991: 5-12.
8. Allard RH. The thyroglossal cyst. Head Neck Surg 1982;5:134-146.
9. Athow AC, Fagg NL, Drake DP. Management of thyroglossal duct cysts in children. Br J Surg 1989; 76: 811-814.
10. Josephson GD, Spencer WR, Josephson JS. Thyroglossal duct cyst: the New York Eye and Ear Infirmary experience and a literature review. Ear Nose Throat J 1998; 77: 642-651.
11. Ahuja AT, Wong KT, King AD, Yuen EH. Imaging for thyroglossal duct cyst: the bare essentials. Clin Radiol.2005;60:141-148.
12. Mondin V, Ferlito A, Muzzi E, Silver CE, Fagan JJ, Devaney KO, Rinaldo A. Thyroglossal duct cyst: personal experience and literature review. Auris Nasus Larynx. 2008;35:11-25.
13. Brousseau VJ, Solares CA, Xu M, Krakovitz P, Koltai PJ. Thyroglossal duct cysts: presentation and management in children versus adults. Int J Pediatr Otorhinolaryngol. 2003;67:1285-1290.
14. Shah R, Gow K, Sobol SE. Outcome of thyroglossal duct cyst excision is independent of presenting age or symptomatology. Int J Pediatr Otorhinolaryngol. 2007;71:1731-1735.
15. Maddalozzo J, Vankatesan TK, Gupta P. Complications asociated with the Sistrunk
16. procedure. Laryngoscope 2001;111:119- 123.
17. Horisawa M, Niinomi N, Ito T. What is the optimal depth for core-out toward the foramen cecum in a thyroglossal duct cyst operation? J Pediatr Surg 1992;27:710-713.
18. Kennedy TL, Whitaker M, Wadih G. Thyroglossal duct carcinoma:a rational approach to management. Laryngoscope 1975;108:1154-1158.
19. Mondin V, Ferlito A, Muzzi E, et al. Thyroglossal duct cyst: personal experience and literature review. Auris Nasus Larynx 2008;35:11-25.