thyroglossal duct cyst

甲状舌管囊肿
  • 文章类型: Journal Article
    目的:口状舌管囊肿是临床上较为少见的疾病。本文对7例患者的诊治过程进行综述,结合以往文献报道,探讨口内甲状舌管囊肿的临床诊治特点。
    方法:对2017年1月至2024年1月大连市中心医院耳鼻咽喉科收治的7例口内甲状舌管囊肿进行回顾性分析。这些病例是按性别记录的,年龄,症状,身体体征,放射学检查,手术方法,术后并发症。所有病例均得到随访,并记录最新的随访结果。
    结果:在7例中,6例患者在手术前接受了喉镜和放射学检查,1名儿童在手术中被发现有囊肿。所有病例均诊断为口内甲状舌管囊肿,并采用等离子射频手术治疗。患者均无术后并发症,出院后6个月随访未见复发。
    结论:口状甲状舌管囊肿临床少见。临床上重视其鉴别诊断,手术前需要仔细检查图像。低温等离子射频冷冻消融术不仅创伤小,恢复快,而且并发症少,复发率低。是一种安全有效的治疗方法,值得临床推广。
    方法:第3级。
    OBJECTIVE: Intraoral thyroglossal duct cyst is a relatively rare clinical disease. This article reviews the diagnosis and treatment process of 7 patients and explores the clinical characteristics of diagnosis and treatment of intraoral thyroglossal duct cyst in combination with past literature reports.
    METHODS: A retrospective analysis was conducted on 7 cases of intraoral thyroglossal duct cyst admitted to the Otolaryngology ward of Dalian Municipal Central Hospital from January 2017 to January 2024. The cases were recorded in terms of gender, age, symptoms, physical signs, radiological examinations, surgical methods, and postoperative complications. All cases were followed up, and the latest follow-up results were recorded.
    RESULTS: Among the 7 cases, 6 patients underwent laryngoscopic and radiological examinations before surgery, and 1 child was found to have a cyst during surgery. All cases were diagnosed with intraoral thyroglossal duct cyst and treated with plasma radiofrequency surgery. None of the patients had postoperative complications, and no recurrence was found in the six-month follow-up after discharge.
    CONCLUSIONS: Intraoral thyroglossal duct cyst is rare in clinical practice. It is important to pay attention to its differential diagnosis clinically, and careful review of images is required before surgery. Cryoablation with low-temperature plasma radiofrequency is not only minimally invasive and has a quick recovery but also has few complications and a low recurrence rate. It is a safe and effective treatment method that is worthy of clinical promotion.
    METHODS: Level 3.
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  • 文章类型: Journal Article
    目的:回顾性总结小儿甲状舌管囊肿(TGDC)的临床特点,调查改良Sistrunk(MSis)手术的疗效,并分析复发风险。方法:回顾性分析2012年3月至2021年12月首都医科大学附属北京儿童医院和保定市儿童医院收治的391例TGDC患儿的临床资料。所有患者均行颈椎超声术前评估。20例进行了磁共振成像,8例进行了计算机断层扫描以进行进一步评估。所有患者都接受了标准的mSis程序,和临床表现信息,手术信息,并发症,并对预后进行分析。结果:391例TGDC病例中,118例(30.2%)有反复颈部感染史,36例(9.2%)曾接受过颈部囊肿和瘘管切除手术,最初诊断为颈部囊肿(22例),TGDC(12例),或分支瘘(2例),在先前的手术中只有6例进行了部分舌骨切除。在15至156个月的随访中,10名儿童出现局部伤口感染,但没有其他并发症的报道。复发率为2.30%,复发时间从0.5到34(平均,7.2)术后月。在泊松回归模型中,检查与复发相关的因素,3个因素的P值<0.05:病变边界的清晰度,手术史,以及与3个危险因素相对应的最大直径和相对风险(RR)值,例如Exp(B),分别为27.918、10.054和6.606。结论:mSis手术在研究中显示出安全性和有效性,并发症少,复发率低,为2.30%。此外,模糊的病变边界,手术史,大病灶直径(>2cm)是小儿TGDC复发的独立危险因素。证据等级:IV。
    Objectives: The study aims to retrospectively summarize the clinical features of pediatric thyroglossal duct cyst (TGDC), investigate the efficacy of the modified Sistrunk (mSis) procedure, and analyze the recurrence risks. Methods: The clinical data of 391 children with TGDC admitted to Beijing Children\'s Hospital affiliated Capital Medical University and Baoding Children\'s Hospital from March 2012 to December 2021 were retrospectively analyzed. All patients underwent cervical ultrasound for preoperative evaluation. Twenty cases had magnetic resonance imaging and 8 cases had computed tomography for further evaluation. All patients underwent the standard mSis procedure, and clinical manifestations information, surgical information, complications, and prognosis were analyzed. Results: Among the 391 TGDC cases, 118 (30.2%) had a history of recurrent neck infection and 36 (9.2%) had undergone previous neck cyst and fistula resection surgeries, initially diagnosed as neck cyst (22 cases), TGDC (12 cases), or branchial fistula (2 cases), with only 6 cases having undergone partial hyoid bone resection in the previous operation. During the 15 to 156 months of follow-up, 10 children experienced local wound infection, but no other complications were reported. The recurrence rate was 2.30%, and the recurrence time ranged from 0.5 to 34 (average, 7.2) months post surgery. In the Poisson regression model examining factors related to recurrence, the P values of the 3 factors were <.05: clearness of the lesion boundary, surgical history, and maximum diameter and the relative risk (RR) values corresponding to the 3 risk factors, such as Exp (B), were 27.918, 10.054, and 6.606, respectively. Conclusions: The mSis procedure demonstrated safety and efficacy with fewer complications and a low recurrence rate of 2.30% in the study. Furthermore, the indistinct lesion boundary, surgical history, and large lesion diameter (>2 cm) were independent risk factors for recurrence in pediatric TGDC.Level of Evidence: IV.
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  • 文章类型: Case Reports
    甲状舌管囊肿代表了颈部的先天性异常,很少在动物中记录。虽然以前在狗中报道过,猫,马,山羊,猪,和小牛,从来没有鸟。本报告描述了母鸡甲状舌管囊肿的罕见病例。在白喉粘膜皮肤病变后,进行了Transylvanian裸颈母鸡的尸检。尸检显示,囊肿样结构,位于左甲状腺尾边缘水平0.5厘米。组织学上,囊性肿块,以1-2个分化良好的纤毛立方细胞为边界,呈现甲状腺转录因子1的核免疫反应性。据作者所知,以前没有禽类甲状舌管囊肿的记录。此外,这是第一例描述母鸡甲状舌管囊肿的病例。
    Thyroglossal duct cyst represents a congenital anomaly of the cervical region, rarely documented in animals. Although previously reported in dogs, cats, horses, goats, pigs, and calves, never in birds. This report describes a rare case of thyroglossal duct cyst in a hen. A necropsy of a Transylvanian Naked Neck hen carried following diphtheroid mucocutaneous lesions. The necropsy revealed a large, cyst-like structure measuring 0.5 cm at the level of the caudal edge of the left thyroid gland. Histologically, the cystic mass, bordered by 1-2 lines of well-differentiated ciliated cuboidal cells, presented nuclear immunoreactivity for Thyroid transcription factor 1. To the best of the authors\' knowledge, there are no previous records of thyroglossal duct cysts in avians. Moreover, this is the first case describing a thyroglossal duct cyst in a hen.
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  • 文章类型: Case Reports
    背景:甲状舌管囊肿(TDC)是中线颈部的常见病变,起源于甲状舌管的不完全退化。通常在学前患者中观察到,手术是预防感染的首选治疗方法。这里报道了一例新生儿患者的偶然诊断。
    方法:一名3周大的男婴因母乳喂养后体重下降和呕吐。在诊断为肥厚性幽门狭窄后,婴儿接受了幽门肌切开术。在气管导管放置期间,麻醉师注意到中线颈部肿块的存在。术中超声证实了TDC的嫌疑,所以,尽管病人年龄大,我们根据Sistrunk的手术进行了病灶切除,以避免未来的并发症和麻醉。
    结论:即使TDC是儿科患者的常见病变,文献中描述了不同类型的新生儿病例,所有的症状。准确的体格检查和超声检查是区分TDC和其他中颈部病变的重要诊断工具,特别是异位甲状腺组织。Sistrunk手术是最有效的手术方法。当新生儿做出诊断时,我们建议推迟手术,除非婴儿需要全身麻醉进行其他外科手术,就像我们的情况一样。
    BACKGROUND: Thyroglossal Duct Cyst (TDC) is a common lesion of the midline neck, originating from an incomplete involution of the thyroglossal duct. It is typically observed in pre-scholar patients and surgery is the treatment of choice to prevent infections. Here reported a case of incidental diagnosis in a newborn patient.
    METHODS: a 3-week-old male baby was admitted to our hospital for weight loss and projectile vomits after breastfeeding. After a diagnosis of hypertrophic pyloric stenosis, the baby underwent pyloromyotomy. During the endotracheal tube placement, the anesthetist noticed the presence of a midline neck mass. The suspect of TDC was confirmed by an intraoperative ultrasound, so, despite the age of the patient, we proceeded with the excision of the lesion according to Sistrunk\'s procedure to avoid future complications and anesthesia.
    CONCLUSIONS: even if TDC is a common lesion of pediatric patients, anecdotical neonatal cases were described in the literature, all of them symptomatic. An accurate physical examination and ultrasound are essential diagnostic tools to distinguish TDC from other middle neck lesions, particularly ectopic thyroidal tissue. Sistrunk\'s procedure is the most effective surgical approach. When diagnosis is made in a newborn, we suggest postponing surgery, unless the baby requires general anesthesia for other surgical procedures, such as in our case.
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  • 文章类型: Journal Article
    目的:本研究的目的是分析甲状舌管囊肿(TGDC)的组织病理学特征,专注于“树木化”,在一组接受手术切除的儿科患者中,并评估与临床复发的可能相关性。
    方法:对2015年至2020年在比萨大学小儿外科学部接受TGDC手术切除的所有患者进行回顾性分析;对于每个患者,记录了以下数据:年龄,性别,临床表现,本地化,病变的大小,诊断工具,组织病理学特征,围手术期并发症,复发和随访。
    结果:关于树根化,组织病理学分析后,25/30例患者(83.3%)出现甲状舌管分支。经过3.5年的中位随访,30名患者中只有2名(6.7%),一男一女,分别为4岁和6岁,首次手术后一年内复发。
    结论:TGDC的手术对于儿科外科医生来说仍然是一个挑战,虽然我们大多数接受手术的病例都存在乔木化。关于树木化的作用,我们的研究没有强调关于它们在复发中的作用的足够的结论性数据:相反,它显示广泛切除令人满意,在组织病理学上大多数病例中都存在乔木化。
    OBJECTIVE: The purpose of the present study is to analyze thyroglossal duct cyst (TGDC) histopathological features, with focus on \"arborization\", in a cohort of pediatric patients who underwent surgical removal, and evaluate a possible correlation with clinical recurrences.
    METHODS: A retrospective analysis of all patients who underwent surgical resection for TGDC at the division of Pediatric Surgery of the University of Pisa from 2015 to 2020 was performed; for each patient, the following data were recorded: age, sex, clinical presentation, localization, size of the lesion, diagnostic tools, histopathological features, perioperative complications, recurrence and follow-up.
    RESULTS: With respect to arborization, following histopathological analysis 25/30 patients (83.3%) presented thyroglossal duct branching. After a median follow-up of 3.5 years, only 2 out of 30 patients (6.7%), one male and one female, respectively aged 4 y.o. and 6 y.o., presented recurrence within one year from first surgery.
    CONCLUSIONS: Surgery for TGDC remains a challenge for pediatric surgeons, while arborization was present in most of our cases which underwent surgery. With respect to the role of arborization, our study did not highlight sufficient conclusive data regarding their role in recurrence: instead, it showed wide resection as satisfactory, being the arborization present in most of the cases at histopathology.
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  • 文章类型: Case Reports
    背景:可以在几个不同的位置检测到甲状舌管囊肿(TDC),虽然在文学中,甲状腺内表现很少见。
    方法:我们的患者是一名56岁的女性,被诊断为甲状腺功能减退症,表现为右侧颈部肿块,临床上与甲状腺结节无法区分。细胞学检查显示细针抽吸时外观正常的鳞状细胞。右半甲状腺切除术,组织病理学检查发现一个鳞状上皮衬里的囊肿,与甲状舌管囊肿(TDC)一致。
    结论:我们的建议是诊断甲状舌管囊肿(ITTDC)位于颈前基底肿块前,特别是当患者患有甲状腺功能减退症时。细针穿刺细胞学检查可用于检测良性鳞状细胞,并可排除恶性肿瘤。
    结论:虽然相对罕见,甲状腺甲状舌管囊肿(ITTDC)是一种良性病变,其诊断必须正确确定,才能进行适当的治疗.
    BACKGROUND: Thyroglossal duct cysts (TDCs) can be detected in several different locations, although in the literature, intrathyroidal presentations are rare.
    METHODS: Our patient was a 56-year-old woman who was diagnosed with hypothyroidism and presented with a right-lateral neck mass that was clinically indistinguishable from a thyroid nodule. Cytology revealed normal-looking squamous cells on fine-needle aspiration. Right hemithyroidectomy was performed, and histopathological examination revealed a cyst lined by squamous epithelium that was consistent with a thyroglossal duct cyst (TDC).
    CONCLUSIONS: Our recommendation is to diagnose intrathyroid thyroglossal duct cyst (ITTDC) in front of anterior basicervical masses, particularly when the patient has hypothyroidism. Fine needle aspiration cytology can be used to detect benign squamous cells and may rule out malignancy.
    CONCLUSIONS: Although relatively rare, an intrathyroid thyroglossal duct cyst (ITTDC) is a benign lesion whose diagnosis must be correctly established for appropriate therapeutic management.
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  • 文章类型: Journal Article
    Thyroglossal duct cysts (TGDCs) are unusual remnants of the thyroid gland that are rarely observed in association with carcinoma. The present study aimed to showcase the clinical characteristics, diagnosis and management of patients with TGDC carcinoma. It was a single-center study conducted from February 2016 to February 2020. The study involved the retrospective analysis of a series of cases with TGDC carcinoma. A total of 10 patients were included in the study, of whom eight (80%) were females. Their age ranged from 25 to 48 years with a mean age of 39.1 years. A total of five cases (50%) underwent only Sistrunk\'s procedure, four patients (40%) underwent total thyroidectomy along with Sistrunk\'s procedure and one patient (10%) was treated by Sistrunk operation and lobectomy. In all of the cases (100%), histopathological examination confirmed papillary thyroid carcinoma in TGDCs. In addition, in the thyroid tissue, 2 cases (20%) also had papillary thyroid carcinoma and 3 cases (30%) had papillary thyroid microcarcinoma. Radioiodine was administered in one patient (10%) with suppressive thyroxine. A three-year follow-up with ultrasound revealed no suspicious lesions in any of the cases. Although rare, carcinoma may develop in the thyroglossal cysts. In this situation, both the thyroid gland and different lymph node compartments should be evaluated for malignancy. Surgical intervention is the cornerstone of management.
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  • 文章类型: Journal Article
    甲状舌管囊肿(TDC)是先天性异常,很少发生恶性转化,大约1%的手术TDC表现为恶性变性。治疗管理和随访方法仍然是有争议的主题。
    我们报告3例发生在甲状舌管囊肿中的甲状腺乳头状癌。2例患者术前怀疑诊断,因此有冰冻切片检查的迹象。所有患者均接受了甲状腺全切除术和中央颈清扫术相关的Sistrunk手术。2例合并甲状腺乳头状癌。在所有情况下,都进行了放射性碘131和狂热激素治疗的补充治疗。随访显示无复发。
    甲状舌管囊肿癌的临床表现通常是非特异性的,对早期诊断提出挑战。选择的治疗策略,涉及到Sistrunk程序,甲状腺全切除术,中央颈淋巴结清扫术,以及使用放射性碘131和狂热激素治疗的辅助治疗,能有效预防复发。
    结论:退化性TDC的管理基于多学科方法。TDC的乳头状癌通常具有良好的预后。
    UNASSIGNED: Thyroglossal duct cysts (TDCs) are congenital anomalies that can rarely undergo malignant transformation, with approximately 1 % of operated TDCs demonstrating malignant degeneration. Therapeutic management and follow-up methods are still controversial subjects.
    UNASSIGNED: We report 3 cases of a papillary carcinoma of thyroid occurring in a thyroglossal duct cyst. The diagnosis was suspected preoperatively in 2 patients, hence the indication of frozen section examination. All patients underwent Sistrunk procedure associated with total thyroidectomy and central neck dissection. Concomitant papillary thyroid carcinoma was found in 2 patients. A complementary treatment by radioactive iodine 131 with frenetic hormone therapy was undertaken in all the cases. The follow-up showed no recurrence.
    UNASSIGNED: The clinical presentation of thyroglossal duct cyst carcinoma is often nonspecific, posing challenges in early diagnosis. The chosen treatment strategy, involving the Sistrunk procedure, total thyroidectomy, and central neck dissection, along with adjuvant therapy using radioactive iodine 131 and frenetic hormone therapy, was effective in preventing recurrence.
    CONCLUSIONS: The management of degenerated TDC is based on a multidisciplinary approach. Papillary carcinomas of TDC generally have a good prognosis.
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  • 文章类型: Journal Article
    目的:甲状舌管囊肿(TGDC)是一种常见的颈部先天性肿块。作为TGDC切除的传统手术方法,Sistrunk程序,经常留下可见的颈部疤痕,对改善化妆品效果的需求有所增加。新兴的内窥镜辅助方法为解决美容问题提供了希望。我们进行了范围审查,以评估内窥镜辅助TGDC手术的可行性和安全性。
    方法:PubMed,Embase,和Cochrane数据库。
    方法:从各自的开始日期到2023年1月检索电子数据库。关于手术方法的数据,患者人口统计学,外科手术,提取并分析术后结局。使用JoannaBriggs研究所关键评估清单评估研究的质量。
    结果:文献检索在2011年至2022年间发表了9篇文章。总的来说,这些研究中的85例患者使用各种方法成功接受了内窥镜辅助的TGDC手术,包括乳晕,腋窝乳房,经口前庭,和经口舌下。手术时间因研究而异,范围从50到480分钟。TGDC尺寸范围为直径1至3cm。并发症,包括感染,皮肤瘀伤,和构音障碍,在7例患者(8%)中报告。没有报告转换为开放手术或术后复发的病例。
    结论:内窥镜辅助手术是寻求TGDC切除术的患者的潜在替代方案,具有令人满意的美学效果,同时确保安全。然而,现有证据不足以支持内窥镜辅助TGDC手术优于传统Sistrunk手术的有效性.喉镜,2024.
    OBJECTIVE: Thyroglossal duct cysts (TGDCs) are a common congenital mass in the cervical region. As the traditional surgical approach for TGDC removal, the Sistrunk procedure, often leaves a visible neck scar, the demand for improved cosmetic outcomes has increased. Emerging endoscopy-assisted approaches offer promise for addressing cosmetic concerns. We conducted a scoping review to evaluate the feasibility and safety of endoscopy-assisted TGDC surgery.
    METHODS: PubMed, Embase, and Cochrane databases.
    METHODS: Electronic databases were searched from their respective inception dates to January 2023. Data on surgical approach, patient demographics, surgical procedure, and postoperative outcomes were extracted and analyzed. The quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist.
    RESULTS: The literature search yielded nine articles published between 2011 and 2022. Overall, 85 patients in these studies successfully underwent endoscopy-assisted TGDC surgery using various approaches, including areolar, axillo-breast, transoral-vestibular, and transoral-sublingual. The operative time varied across the studies, ranging from 50 to 480 min. TGDC sizes ranged from 1 to 3 cm in diameter. Complications, including infection, skin bruising, and dysarthria, were reported in seven patients (8%). No cases of conversion to open surgery or postoperative recurrences were reported.
    CONCLUSIONS: Endoscopy-assisted surgery is a potential alternative for patients seeking TGDC resection with satisfactory aesthetic results while ensuring safety. However, existing evidence is insufficient to support the superior effectiveness of endoscopy-assisted TGDC surgery over the traditional Sistrunk procedure. Laryngoscope, 134:3038-3043, 2024.
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  • 文章类型: Journal Article
    背景:儿童颈部中线肿块主要是甲状舌管囊肿或皮样囊肿。甲状舌管囊肿通常有一个相关的窦道,可能一直连接到舌头上的盲孔,而皮肤没有这种联系。这项研究旨在根据我们的患者系列评估中线颈部囊肿的年度感染风险。看看甲状舌管囊肿和皮样囊肿之间的差异。
    方法:在皇家儿童医院看到的所有儿童,确定了在2017年1月1日至2021年12月31日期间接受中线颈部囊肿手术切除的格拉斯哥。在那些在手术切除之前已经感染了囊肿的人中,记录首次感染发生的年龄,并用于计算生存曲线.
    结果:我们确定了53名儿童(29名男性,24名女性),年龄在手术切除时1-16岁(中位数4)。甲状舌管26例,皮样囊肿24例,加上2个不确定的组织学和1个淋巴结。在24个皮肤组织中,4人在手术前感染(17%),其中2例术后复发(8%)。在26例甲状舌管囊肿中,16人在手术前感染(62%),其中5人复发(19%)。到10岁时,78%的甲状舌管和皮样囊肿至少发生1次感染。
    结论:患有从未感染过的先天性中线颈部囊肿的儿童,将手术推迟一年,囊肿被感染的风险为7.8%。
    BACKGROUND: Midline neck lumps in children are mostly found to be thyroglossal duct cysts or dermoid cysts. Thyroglossal duct cysts often have an associated sinus tract which may connect all the way to the foramen caecum on the tongue, while dermoids have no such connection. This study aims to estimate the annual infection risk for midline neck cysts based on our patient series, and to see if this differs between thyroglossal duct cysts and dermoid cysts.
    METHODS: All children seen at the Royal Hospital for Children, Glasgow who underwent surgical excision of a midline neck cyst between 1st January 2017 and 31st December 2021 were identified. In those whose cyst had been infected prior to surgical excision, the age at which the first episode of infection occurred was recorded and used to calculate a survival curve.
    RESULTS: We identified 53 children (29 male, 24 female) aged 1-16 years (median 4) at the time of surgical excision. There were 26 thyroglossal and 24 dermoid cysts, plus 2 with indeterminate histology and 1 lymph node. Of the 24 dermoids, 4 suffered infection prior to surgery (17%), and 2 of these recurred after surgery (8%). Of the 26 thyroglossal cysts, 16 suffered infection prior to surgery (62%) and 5 of these recurred (19%). 78% of thyroglossal and dermoid cysts had at least 1 episode of infection by age 10 years.
    CONCLUSIONS: In a child with a congenital midline neck cyst that has never been infected, deferring surgery for a year comes with a 7.8% risk that the cyst will get infected.
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