Results of Modified Sistrunk Operation in Thyroglossal Duct cyst a Review of 81 Cases

(1)

Vol. 7. No.2. December 2001

Sistrunk~~ ~ 3i %~ {f~J~

Results of Modified Sistrunk Operation in Thyroglossal Duct cyst a Review of 81 Cases

Kyeong Geun Lee, M.D., Poong Man Jung, M.D.

Department of Surgery, Hanyang University, College of Medicine Seoul, Korea

Thyroglossal duct cyst is ectodermal remnant, which may develop along the line of descent of the thyroid gland from the foramen cecum of the tongue to the pyramidal lobe of the thyroid gland. Meticulous dissection of the cyst and duct, along with the body of the hyoid bone is necessary to avoid recurrence. Eighty-one patients with thyroglossal duct Cyst treated at Hanyang University Hospital between January 1980 and December 2000 were reviewed to determine the incidence and to analyze the result of management. The male-to-female ratio was 1.4: 1(47: 34) with a male preponderance. They are most commonly present at 3-8years(54.2 %) of age, but rarely present at infancy. The most common symptom was a painless midline neck mass(76.5 %, 62cases). Eighty-one patients underwent modified Sistrunk operation without evidence of recurrence. Eight-nine percent(72 cases) of these lesions were located between thyroid substance and hyoid bone, and 11 %(9 cases) were above the hyoid bone. There were 22 infected cysts(27.2 %). The Sistrunk operation is a gold standard for treating the thyroglossal duct cysts. For best results in thyroglossal duct cyst surgery, one should make every effort to remove the cyst intact in continuity with the body of the hyoid bone. In our institute, Sistrunk operation modified by the authors showed a good result. (J Kor Assoc Pecliatr Surg 7(2):137-141). 2001.

Index Words: Tfryro!Jlossal duct cyst. Sistrunk operation. Modified Sistrunk operation

. ' .. ' , ;''':''C ," ',)·i;·'{~.h'· ,ii, ';""., . . . ' / •. '

C0ITl'SP9ndellce:P<JfngMah:'~UJ1.g,M.D.;. Deparp:nent of General Surgeryi tColleg~ •. "offMedicine,:;.Harryang. University Hospital, 17 Haengdang-d1Jng, ,. SungdO~g-Gu,/¥01fl133-792, Korea'

.• . " .0

%-€:- 7}AJ- ~S:7} ~-€:- 7]~.Q.~, 5:o} J.] 7] oj] ~7]{[lJ ~ T~~ w~~'iii°] ~]*S1~ ~%Olr-}. {[lJ-€:- ~~ ~ ol,§:}

~ 7a"'}~.Q.~ r11-¥-~ {[t!~

T

'Ur-}.

1J'AJ-~ 1!{:PcH~'~ ~A~.g. 7cl-¥-~ 71:t!% ~Ajo}~ llHo}

~-3J~ ~~ ~ ~:&~ °VJ-oJ] ~t'}oj A~Zlr-}.Jl ~DjA:j'Ur-} .

utc.Vi

T7cl-¥-~ ~AjO}~ 71:t!~ ~A~:i!J-7a:i!J- ~-¥-'§:}~ °lt~

~ 7j:2f~ {[lJ ~ T~%

-'f1tH"'i

~ ~Jlt'}r-}.

(2)

A~A}%.g. 81al]Qj ~~% ~ii}aj ~o}Qj {f"'J{i "'~{1:tt%

01] ~cj ~o}Qj Aal:ll, ~~ 4l-%l;']71, -U~%, -'H!7]i.§ %

~"'J~ ~Aa% ~~ii}~q.

1980\101];'1 2(0)\1;'}0]01] ~ ~°J:rll~~-%l ~0}913!}01];'1

{f,*{i 1l.{1:tt%.£.£ {ltJSlcj Modified Sistrunk operation

~~% ~.g. ~A} 67~3!},

Et

~-%lojV1 {ltJSlcj ~~}~~

-r AR~Slcj ~-%l.£.£ {i-%l-'8 ~A} 14~% rll"'J.£.£ iiH,

Qj.!j'-7]~% £rll£ -rz;J:~ ~~% ii}~q.

Modified Sistrunk operation (Author ' s method)

~-%l01]"'11= q%3!} ~.g. ~i.§ Sistrunk ~-61% ;']3~ii}~q (.:Ill 1). l)tt%o] ~ 1= lIJ-¥-Qj ~ 3~ ~7R-r tt%% ~Qj :Qll]

~~-r, 2)1l.{!Qj 'T-3~01]u:j-c} l'i]~% ~~ii}Jl, 1l.~Qj %~]

-¥- ii}llJ01] ~011 ~1= -2-~~ -i~A~~-2-(stemohyoid muscle)

% 1l.~011"'1 ~~-r, 3)1l.~Qj %~~]-¥-!4 A~~~Zf(lesser comu)Qj ~7-l]-¥-~oj]"'l %~~]-¥-~ rll-¥-~ ~Aj]~q(5-10mm).

4)1l.~Qj ~Aj]-r 1l.~ %~~]-¥- "'JllJ01] -¥-~Slcj~1= 0V~~-2-

(geniohyoid muscle), o]A~-2-(genioglossus muscle)Qj ~-¥-%

1l. ~ %~1-¥-!4 ~.g. 'f~ 0]£ -%l%i.§.Q..£ l:!{~ -r -&1 Qj 71 A~-¥- 011"'1 'T-~ ~~];?:~3!} ~ol ~Al]ii}~q. 5)~Aj]-'8 A~~3!} -2-

~.g. t-~"'}~ o]%iiH *-%lii}~q. "'J7]Qj ~-61.g. Sistrunk

~-613!} l:I].ii!.ii}aj ~ trJ11l.~ ~ A~~"'JllJQj ~~~];?:~Qj ~Aj]

~~7} 3Jl, 1l.~01]A1 o~~oJ1 o]E--'c ~~3!}Aa % -&1Qj ~

-'8 -2-~~ °11l.~-2-°1 -&1Qj 7]A~-¥-01]"'1 O~~7J}A]Qj -%l~?@

~~7Hcore-out procedure) ).~~~% ~~.£.£ ~q. !E~

-&1 Qj 71 A~ -¥-~ ~ -¥- Al]li ii}-'c Horisawa Qj shallow core procedure!4 l:I].ii!.ii}~% trJ1 .!l!.q Zl-~~ ~-610]c}Jl ~ ~

~~q. °lc~~ ~-61Qj ;,13~ ~3!} ~-%101V1 ~~£ {ltJSlcj

~~~~~%1l.~,*~~.g.1l.~-¥-~~tt%?@~Qj~

~.g. ~;lSlq. u:j-c}A1 ~o}Qj ~VJ{i 1l.{!tt%Qj ~~.g. Zl-~

~ ~?@ Sistrunk ~-61.£.£ ~ -r ~.g. ~ 3!}~ .!l!. ~ ~ ~ %

~.£.£ A}li-'8q.

'it ajQj ~sc.1= 1.4:1(47:34)£ 'itA}01]ll] ~~q. ~~Qj ~

~ ~lli tJAl, 7}:AJ cji{:! ~0}1= ).~-r 14~ o]~Jl, 7}:AJ t..J-

Fig. 1. A; Sistrunk operation. B; Shallow core-<>ut procedure. C; Modified Sistrunk operation. Diagram of the common running pattern of the thyroglossal duct and illustration indicating the area to be resected. Anatomic relationships of the tongue (TG), hyoid bone (HB), ster- nohyoid muscle (SM), mylohyoid muscle (MM), geniohyoid muscle (GM), thyroid membrane (THM), hyo- epiglottic ligament (HEL), epiglottis (EG), and base of the tongue (BT), are illustrated²¹.

(3)

Fig. 2. Age distribution of thyroglossal duct cysts.

°17} m.g. ~:A}~

lS/11

~q. 1-\1~ ~o}~

3-S/11

ul~~ ~ 0}7} ~~11~ 54.2 %~ 7.}/Zl-t}~Jl, O-P11 ul~~ ~o}~ 2~

oJl ~JI}-t}~q(.::l~ 2). 1-\1~ t:J-Al~ ~AJ.g. 4'-~Ad

%-%01

62Cll5'. ~~11~ 76.5 %5'. 7}AJ ~J1Jl, T.:g-oJl~~ ~Ad ~l:l1 12Cl](14.S %), %~Ad %-% 7Cl](S.7 %)~ q.

Sl ~ ~ ~o}~ 67~.g. ~~oJ1A1 7.1% {It;±~01 y~~ ~

o}olJl, 14~.g. Et~~oJ1A1 {It;±~01 ~7.}7.1li~ ;<R~~01

~~~5'. ~~B ~o}~q. ~~oJ1A1~ {It;±.g. t:J1.!f-~ ~i:':j

J!} °1~3:j ~"'}~~5'. {It;±~ y~-t}~Jl, 6ClloJ]A1 )JAJJd

%~~5:7a"'}(thyroid scan)~ A1Zi~-t}~~c11 01 ~.q..%.g. ;<R

~01 1 Cl], 'cl-%-~ ~~17} 3'}.q..oJl

ZfZf

7.1.q..~ ~~ 2Cl], 'cl-%- 01 )JAJJd JI} 7,{0 1 %~ 0 1 ~ 1 Cl], 'cl-%-o 1 A~ -tH] ~) ~ 1 Cll!i}

'cl-%-01 A~~oJl JlAcl~01'U~ 1 Clmq. 67~~ 66ClloJjAl l(!~

Sistrunk ~~% A1Zi~-t}~Jl, 1ClloJ]A1 '?:l~~5'. '?l~R ~7R ':Q

Jlfl~~ l(!~ Sistrunk ~~% A1Zi~-t}9Jq. Et ~~01jAl ~7.}

~lli ~ ;<R~B 14~~ ~o}~ T.:g-01l~~ ~Ad ~l:l1 6Cl],

~/ZVcl %-% SCll~q. ~~oJl"'l 21l~ l(!~ Sistrunk ~~ ~ 1Cl1oJ]"'1 ;<RY~% -t}~~cl1 ~-t}01l ~JAJ ~~~oJl ~~ 'cl-%- 01 A~J:j t;±~ ~;<115'. ~lli~~q. )JAJJd A~{!'cl-%- .y~ ~ 11.~J!} 11.~ AJBJ~ 11.{!~ 1'~13:j ':Q ~~11;z:~~ ul~;<115'. ~ A~-t}~ A~~ ':Q 11.~ AJBJ~

'cl-%-Ad

;<R~.g. 1Cll£ \j}~q.

~PJJd 11.{!'cl-%-.g. t:J1.!f-~ ~.!f- ~oJoJl ~7.1-t}~c11, A1:A}%

01 ~~~ Cl1oJl"'1£ ~.!jL ~oJol 77Cll5'. t:J1.!jL~9Jq. ~l(!~

~7.1~ y~ Al°F01l"'l 'cl-%-~ ~~1~ A~~J!} )JAJJd ",}olO1l

'U~ A~~-o} 'cl-%-01 7201](89%), A~~AJ 'cl-%-01 9Cl](1l %)~

~uj, ~.!jL ~oJ% '):!01\:! ~.q..~ 4Cl](4.9 %, ~-:3, .q..:1)~q.

'cl-%-~ '?:l~ 5:/j.g. 27.2 %(221S1)oJl"'1 {!{}~~~I1], 21l~ y

~t:J-Al '?:l~01 %~B ~.q.. 22.4 %(15/67)01 ~Jl, ;<R~Cl101l"'l

~ 50 %(7/14)omq. 21l~ 7.1li t:J-Al y.°101l rr}~ '?:l~~ l:l1

%.g. 0-P11~ 1 Cll£ \j}~Jl(0/2), 1-3/11~ 26.3%(5/19),

3-5

¹

11

20 %(4/20), 5-S/11 13.3 %(2/15), S/1] ol AJ.g. 36.4 %(4/1l)~

~~q. ;AR~~ ~.q.. 14oj]~ 7oj]oJ]A1 ~l(!°1 T.:g-~ ~Ell~

~C9

.2-1.:g-%

~-o}C9 ~Ad ~l:l]7} ~)~q. rr}c}"'l 21l~ y~~

;AR~~ ~.q..~ '?:l~o] %~B ~.q..7} ~-o}71 II1l~01] AR y~

A 1 01 aj %0] rr}~ y ~) q.

Jd

~ 3:j ~5'. A~

Zl

T.:g-.g. 1 Cl] O1jA1

£ ~7,1~ y \j}~q.

)JAJJd A~{!1..-J%-JI} %~B Jd~Ad 71~.g. 7oj](S.6%)01]Al

~y'U~~c1] %~ 71~~5'.~ {]~ ~~~~(2ojj), t;±A~5:cfl

(2Clj), Ifl7]~(2oj]), ~01%(1oj])01 'U~q.

)JAJJd A~{!'cl-%-.g. i9~ 7]A1.!f-01jA1 )JAJJd~ 7]~;Z:~'?l

)JAJJd ^71]~ol

'?J{l

4-72f- ",}o] ~A~ ~ ~:§t~011t~% A]

Y. -o}7J-o}~ -o}7JJdAJoJ] 'it0}'U~ .2-1JlR~~ ~3:j°lc}Jl ~aj A~ ~q. O]ll~ )JAJ-'d~ -o}7J 1'~]3:j.g. 7-102f- ",}O] t:J1.!f-~

%y~711-} 12f-ol~ 7,;)~5'. ~01 ~)~y., \j}01:A]:A] ~Jl AJ~

11].¥.~ l'~]3:j0l 'it0}~)~ ~.q.. AJIi]/11.¥.~ ~l:llO1] ~~R 'cl-%-

% ~

Ad

-t} 71] B q. 1..-J%-.g. 1t ~% 71 ~ ~5'. 11. ~AJ 'cl-%-J!} 1t

~-t} 'cl-%-~5'. T~ ~ql,2.

)JAJ-'d 1t{!'cl-%-~ ~~113:j~ l{l£~ ~aj{l 7,;) 01 \j}~y.

-T

~.!f-~ -'d~Ad 71~~ 7}AJ l{l£7}

it.g.

7,;)~5'. ~ajA~ 'U~

uj, 5:0}~~ o}L.Jc} Ad~oJ] 'U01"'1£ ~-ol {!{}~~ 7]~01q.

Torsiglieri %3.g. 481 ojl~ ~-¥- Jd~Ad %-%~ ~~O1]"'l IR7]

~(32 %), ^~VJ-'d1t{!'cl-%-(30 %), *~'cl-%-(1S %)~ l{l£M

~Jl-o}~Jl, Woussattas %4.g. 267Cl]~ ~~O1l"'l )JAJ-'d A~{!

'cl-%- 26%, AR~ 7]~ 23%~ ~Jl-t}~q. ~~~ ~.q.. 1999~

lJ}/Z] ~j1] -T~.!f- 7]~ 335Cl]~ Sl oj]~ 7.}:Al-t}C9 24.1 %~ AJ

t:J1l{l£~ ~~q. Ad~oJl rr}~ l{l£~ 'it, C9~ 7.}01~ \j}~

7,;)~5'. ~ajA~ ~)~uj, 7}AJ~-ol ~/j~~ y.°l~ 2-10/1] ~ 7,;)~5'. Guarisco %5,6.g. ~Jl-t}~Jl, Solomon %7£ ~A~ llJ£

oj] ~01 'it1..1~ 7.}ol~ \j}~~uj, 7/1] 01-t}~ ~:A}7} ~~1]~

2I3~ 7.}/Zl~r:1Jl ~Jl-o}~q. ~~~ oj]~ S/1] °l-o}7} Sl.9%

~q. Josephson %8.g. ~:A}~ 65%01]"'1 4'-~Ad %-%% 2f-5:5'.

t.11~-t}~qJl ~Jl-t}~Jl, ~-t}~~, 7]{J%~ ~AJ ~~£ 'U

%

Y

~qJl -t}~~c1], °1~ 'cl-%-~ ~7.1oJ]rr}c} ~%~~~

l.H

11]it⁰

l

'cl-%-~ ~l:ll%O1] {J'ij-oH t:J1.!f-~ ~01Y.~cl], 01 uJl %-%~ :'171 ~7} ~.g. %~ %~ ~AJ ~5'. t.11~-t}71] B

(4)

q. Solomon !§..1:i!} Sigmund %9.g- 'i:l~o]~-i::- '-J%-Qj tl]%

% 45%, 35%e}:iL .!i!.:iL"}~:iL, o]lHl 'i:l~.g- %-.B..~ ;;\~~

Qj i'1~ .B..j:e}:iL ,,}~q. ~~Qj ~'i:l tl]%.g- :t]~ ~]liQj

7d-9- 22.4 %, ;;\~.y~Qj 7d-9-50 %Qj 7J'i:l~% .!i!.~tl.

{[AJ{i l1{!l;t%-Qj ~B.g. 7c!~~ ~~:i!}, o]~~ 7a A}.£

t:JlJf--lE- ~Bs:j-i::- -?;i0] .!i!.%-o]q. Jl~tf l;t%-Qj !f1~]7} ClJ]~

~~ 7d-9--i::- 7dJf- B* ~oa, {fAJ~ %!f1~j: 7a A}, 7dJf- ~

%3l} %Qj tlJA~ ~BQj ~%% ~-i::- -?;i0] ~1(1Qj 5~Jf-~~

T~ ~ ~.f W~~% ~0]-i::-101] ~%o] ~ 'T- ~q. Brewis

%1O.g. {[-'cf~ J.~{!l;t%% .y~"}-i::- o]tl]~.f:i!}, j:o}~:i!} Qj

A}~ AJt:Jl.£~ ~A}oJ]Ai ~BQj ~~ ~ 0]j:J.c! {fAJ{iQj e:j

Jf-~ ~~"}7] i'15~ 7dJf- ~%3l} {lA}~ ~§.~q:iL "}~-i::

t11, o]tl]~.f:i!} QjA}Qj 60%, j:o}~:i!} QjA}Qj 3O%oJ]Ai ~

~oJ] ~%3l} {lA}~ l-]<5~"}-i::- -?;i.2-.£ ~As:j~ ~%3l}7} 7} AJ {i~"}-i::- ~ ~ {ll-}e}:iL ,,}~q. g:~ .y~tlJ~oJ]~~

o]tl]~.f:i!} Qjl-}Qj 35%7} 1(1~ Sistrunk ~-61% "}~:iL, j:

o}~3lj- Qjl-}Qj 47%7} K~ Sistrunk ~-61%

"H

j:o}~:i!}

Qjl-}Qj .y~ ~i'17} ,€-Li %~!f1,,}~l-i ~ ~ {lA}oJ] ~~Ai

-i::- 0]1l]~.f:i!} QjA}oJ] 1l],,}e:j ~~"}L}:iL ,,}~q. ~,,] j:o}

.!f7dJf- ~1(1:i!}Qj ~~o] 117] !IJl{toJ] ~~oJ] {}B"}~Ai~

~.g. Ac!~.5:.~ ~-i::-q:iL Ahuja %1I.g. .!i!.:iL,,}~q. Je.]:iL 0]

j:J.c! {[AJ{i0] Qj~~!IJl {[AJ{i %i'1~j: {ll-}-i::- ~ ~ {fAJ {i ~ o]j: {fAJ{iQj i'1~]~ ~~ ~.2-.£M~ 0]j:J.c! {fAJ~%

{[AJ{i J.~{}~%.2-.£ -'L{I,,}:iL ;<j]7i"}-i::-[~] -'L-i::- {fAJ~ 11{!

~% .y~ .f A~~ .y ~-i::- {[AJ{i 7]-i5- Ai,,}~Qj ClJ]tlJoJ]

Pi

.g. .5:.%0] -Bq:iL ~ajhj ~q8 . .!f 7dJf-oJ] A~7]-i::- {i~iAC! 7]

~~ 0]j:J.c! {fAJ{i, %11Jl;t%-, oj,,} ~3l}{i'i:l, A~7]~, ~{!

%, o],,}{i % oJ:, {fAJ~ % oJ:, 7]~% %.g. {fAJ{i A~{! ~

%:i!}Qj ~~~B% .B..~q. Samuel %12.g. it-g-AJ l;t%-Qj 1l]

%% 24 %.£ .!i!.:iL"}~:iL, Solomon %7.g. 3OOClJ]Qj {[AJ{i J.~

{}l;t%Qj -lE-~ oj] Ai 8.6 %~ .!i!.:iL"}~:iL, 3OOClJ]~ 7dJf-~oJoJ]

i'1~] "}7]?£.g. l;t%o] 47ClJ] (15.6 %, ,*:28, -9-:19).£ .!i!.:iL"}~

q. ~ ~ToJ]l-i.5:. J.~-g-AJ l;t%Qj 1l]%0] 11 %~ .!i!.e:j q~

.!i!.:iL%:i!} ~}o]~ .!i!.0]7] ?£~.2-tf, 7dJf- ~oJoJ] i'1~]"}7] ?£

.g. ~%.g. 4ClJ](4.9 %, ,*:3, -9-:1).£ 1l].llL~ £%~q. O]AJoJ]

Ai .Jl~~ !:I}Q} ~o] {fAJ{i J.~{!~%-.g. t:JlJf-~ J.~-g-"6} 7dJf-

~oJoJ] i'1~]~% ~.y ~.2-uj o]-i::- {[AJ~ J.~{!l;t%% {IB

"6}-i::-[~] ~.g. BAi7} ~ .y ~q.

~;;\~ {fAJ{i J.~{!l;t%Qj ~]li-i::- Sistrunk operation 0] K

~ ~-61.2-'£ s:j ~ ~ -i::-[~] o]-i::- A~ -g-% ¥. ~~ J.~ -g-oJ] Ai u~"*

oj] 0]E--i::- ~~1]~3]% D~"*% ¥.~-8}e:j ~;;\1]-8}-i::- 31 0] .y~

Qj ~~ A}"5JO]q(J~ 3). 1893\1 Schlange¹³-i::- )J-AJ~ 11{!

l;t%Qj 'T-~oJ]Ai it-g-Qj ~;;\1]7} ;;\~~% ~~'T-~q:iL ~~%

.!i!.:iL ,,}~:iL, 1920\1 Sistrunk¹⁴.l5

-i::- Sistrunk ~-61 % .!i!.:iL ~

~{toJ]Ai q%:i!} ~o] 7]~-8}~q. "Sistrunk ~-61.g. 7dJf-%- oJ Qj ~ 1(1 oJjAi J.~ -g-% ute} i'~] ~ ~.g. l;t%-% 'tt7] 7] ?£:iL life.].f, A~-g-Qj ~~Jf-~ %-~~.£ 2-3 mm7c!.£ ~;;\1] .f, 11 -g- AJtlJ.2-.£ ~1(1 ~~1]~3]% ¥.~-8}e:j ~%-~.2-'£ life.] .f,

~Qj 7]AiJf-oJjAi D~"* ~ ~Qj

:c%*

.¥.~5~Ai {!Qj i'~]~%

~;<j] "6}-i::- ~-61 ~.£(core-out procedure), J.~ -g-oJ] Ai u~"* lJ}7]

-i::- .!i!.%- tlJA}AJ.2-.£ 3]7d 6 mm 7c!.5C .. Qj life.]7} ~.B..,,}q":iL 7]~"6}~q. o]-i::- l;t%oJ]Ai J.~-g-lJ}7]-i::- i'~]~o] "6}t..j-Qj {!.Q.

.£ s:j~~.2-t..j-, 11-g- 3] AJ tlJ oj] Ai ~Qj 7]AiJf-lJ}7]Qj ~~] ~

3]A}O] Qj i'~] ~.g. 50 %0] AJoJ] Ai e:j l~ 7~Qj {!.2-.£ s:j~ ~.2-

uj, o]%.g. ql-] ¥..5:.%0] .2.. oJ:Qj e:j li ~.g. {!.2-.£ -lE-7]s:j

~ D~"*oJ] 0]E-7] !IJl{toJ] A~-g- AJtlJQj p]~;<j] {!.g. ;;\~~Qj

~~o] ~ .y ~qI6-18. o]li~ 5~Jf-~~ ~~ !IJl{toJ] Ai7}%

.g. ~Qj 7]AiJf-oJ]Ai D~"*lJ}7]Qj core-out procedure~- A~E:j=

~ t:Jl{} Sistrunk operationo]tf, HorisawaQj shallow core- out procedureoJ]Ai .!i!.q it-g-Qj ~;;\1] ~i'1Q} it-g- AJtlJQj ~

~1] ~3] Qj ~ ;;\1] ~ i'1 ~ 3] 7d 10 mm7c!~.£ k~ 71] -8}e:j ~ Qj 7]

Ai Jf-lJ}7] 7~~I],,}~q. ~Qj 7]AiJf-Q} D~{! A}O]Qj 'tt0}~-i::

{!oJ]Ai A~J.C!-B ~~~.g. T 7J41.£ 1l~~s:j:iL T 7J41Qj 7c!AJ~

~ "'~]if%oJ] ~'i:l.g. {t;<j]~ ~.2-7]7] ?£7] !IJl{toJ] ~ 4;: oj]

'tt0}~-i::- {!.g- {fAJ~ it{!l;t%Qj ~ .f ;;\~~oJ] 3.71] 7]e:j"6}

-i::- ~A}7} o}\:i 31.2-,£ A~zt-Bq. {fAJ{i A~{!l;t%Qj .y~oJ]

Ai A~-g-Qj ;<j]7i~ ~i% ;;\1]<j-~ Schlange ~-61Qj ;;\~~o] K~

Sistrunk ~-61.!i!.q ~.g. ~~.g- D~"*:i!} J.~-g-l-}oloJ] tlJA}AJ.Q.

.£ nlhjAi ~~-B o]li~ ~.g. i'~]~Qj p]~;;\l] nJl{to]e}:iL ~

ajhj ~-i::- !:I}-i::- AJ7]oJ]Ai ~B-~ 5RJf-~~ ~J.c!.2-~ 11~01

7}-i5--8}q:iL ~ .y ~q . .!i!.:iLoJ] ute} ~}o]-i::- ~.2-t..j-Sistrunk

~-61 .f ;;\~~%.g. 4-7 %7c!.5:..£ .!i!.:iLs:j:iL ~q. Brereton %19 .g. tfO]7} ~e.]:iL, 'i:l~o] ~-i::- 7d-9- ;;\~~%.g. ~q:iL -8}~

.2-uj, Hawkins %20.g. 7"'~] O]AJoJ]Ai-i::- ;;\R~Qj ClJ]7} -8}tf.5:.

ict~.2-t..j-, 7"'1] o]-8}oJ]Ai-i::- ;;\R~% 16 %~ .!i!.:iL-8}cj t..j-o]-i::-

~ .B.. ~ i'1 ~.B..j: e}:iL -8}~ q. Horisawa %21.g. K ~ Sistrunk

~-61 Qj 1(1 ~ ~ shallow core-out procedure.£. 2.9 %Qj ;;\~ ~

%% .!i!.:iL-8}~-i::-[~1, o]-i::- 11-g- AJtlJQj ~~1]~3]Qj ~;<j]l-] 11 -g- AJtlJQj ~~1]~3]% 2-3 mmQj 3]7dQj ~;<j] ~~~.5:. ~

.g- ~:i!}~ ~%.y ~%% Qjp]~q. Ai7}%Qj ~-61:i!}

Horisawa %Qj ~-61.g. {}~~ .y~.£ ~5R ~ .f w~~:i!}

(5)

~~ °l~AJ-El1Qj {:}~Oll ~~J% pl~

'T- VC}JI A}li'tlll

~i51 ~o}OllAi A~~ol

0Pd

~1: 'T-~~

78Jf--

AJ~ ~AJtlJQj

~j~l~~%

i5:lgj 7] APr-OllAl

;Z1171 i5

}-c

~~~~ ~ ~ ~~

°l~ AJEl1~ ~~

'T- VJI,

~.g. ~:i!j-~ ~%

T

~}c}JI

A}

~VJ-{i

AJ{!'cl-%.g.

eliiL~ ~~

{i{lAcl f7S.!f-

~~~~

t:J1.!f--lf:-

T~~M, ~]li:£]-c

{i{lAcl

7]~olg·. JC,L-}

Ol-c f 78.!f- 7]{!

~A~gj /(a~~

oltR-'4

t~.!f-~~ A]~:i!j- 78~%

e}

FJ-~~ ~ /(a~~ ~\:!- ~ 'T-~Ol

Al"&'tlc}-c

~;Z11% ~R5'..

~c}.

el

2~1~ 'T-~ ~ ;z~~'tl

78Jf---c

{:}~Qj

e]%ol

~JI,

°l~ ~~ 'T-~AJ-Qj

Olaj%.g.

A~~ ~ ~ ~ ~~%% 1:?Jl

~

'T- Vq. utctAi :QAJ{i

~-\1'cl-%.g. ~71 ~B ~ ~1:

~liUl 2~1~ ~lli~ ~~~M, ~ ~ ~~% ~ A~~% ~

~

'T- Vc}.

A1A}~.g. ~~ Sistrunk ~~% ~i5}O:j ~o}gj

:QAJ{i AJ-\1'cl-%gj

~ ~ ~.g. ~:i!j-~ ~~q.

1. Hoyes AD, Kershaw DR: Anatomy and development of thyroid gland. Ear Nose Throat J 64:318-333, 1985 2. Sadler TW: Langman's medical emb,yology, (4th ed),

Baltimore, William Wilkins, 1985, Pp293-295

3. Torsiglieri AJ, Tom L, Wetmore R, Handler S, Potsic W: Pediatric neck mass; guide line for evaluation. Int J Otorhinolaryngol 16(3): 199-210, 1988

4. Moussatas GH, Baffes TTG: Cervical masses in infants and children. Pediatrics 251, 1963

5. Guarisco JL: Congenital head and neck masses in irifants and children, Part 1. Ear Nose Throat J 70:40-47, 1991 6. Guarisco JL: Congenital head and neck masses in infa-

nts and children, Part II. Ear Nose Throat J 70:75-82, 1991

7. Solomon JR, Rangecroft L: Thyroglossal-duct lesions in

childhood. J Pediatr Surg 19(5):555-561, 1984

8. Josephson GD, Spencer WR, Josephson JS: Thyroglossal duct cyst: the New York Eye and Ear infirmary exper- ience and a literature review. Ear Nose Throat 1 77(8):

642-65 J, 1998

9. Sigmund HE, Shandling B, Stephens CA: The problem of recurrent thyroglossal duct remnants. J Pediatr Surg 19(4):437-439, 1984

10. Brewis C, Mahadevan M, Bailey CM, Drake DP:

Investigation and treatment of thyroglossal cysts in chi- ldren. 1 R Soc Med 93:18-21, 2000

1 L Ahuja AT, King AD, Metreweli C: Sonographic eval- uation of thyroglossal duct cysts in children. Clinical Radiology 55:770-774, 2000

12. Samuel M, Freeman NV, Sajwany MJ: Lingual thyrogl- ossal duct cyst presenting in infancy. J Pediatr Surg 28(7):891-893, 1993

13. Schlange H: Ueber die fistula colli congenita. Arch Klin Chir 46:390-392, 1893

14. Sistrunk WE: The surgical treatment of the thyroglossal tract. Ann Surg 71: 121-123, 1920

15. Sistrunk WE: Technique of removal of cysts and sinuses of the thyroglossal duct. Surg Gynecol Obstet 46: 109-112, 1928

16. Arthow AC, Fagg NL, Drake DP: Management of thy- roglossal duct cysts in children. Br J Surg 76:811-814, 1989

17. Soucy P, Penning J: The clinical relevance of certain observations on the histology of the thyroglossal tract. J Pediatr Surg 19:506-509, 1984

18. Rakesh KC, 10hn M, Paula K: Histological characterization of the thyroglossal tract:Implication for surgical management.

Laryngoscope 1ll:1002-1005, 2001

19. Brereton RJ, Symonds E: Thyroglossal cysts in children.

Br J Surg 65:507-508, 1978

20. Hawkins DB, Jacobsen BE, Klatt EC: Cysts of the thyroglossal duct. Laryngoscope 92: 1253-1258, 1982 21. Horisawa M, Niinomi N, Nishimoto K, Matsunaga K,

Ogura Y, Watanabe Y, Ando H: Clinical results of the shallow core-out procedure in thyroglossal duct cyst operation. J Pediatr Surg 34(11):1589-1592, 1999

Results of Modified Sistrunk Operation in Thyroglossal Duct cyst a Review of 81 Cases

Sistrunk~~ ~ 3i %~ {f~J~