Risk of recurrence in children operated for thyroglossal duct cysts: A systematic review

PURPOSE: To determine the rate of recurrence following surgical treatment of thyroglossal duct cysts (TDGCs) in children. METHODS: A search of electronic databases (Pubmed and MEDLINE) was performed in order to identify studies concerning surgical treatment of TGDCs in children published between 1980 and 2012. The following terms were used: "thyroglossal duct cysts", "recurrent", "recurrence", "children", "pediatric". RESULTS: Sixteen articles were selected with the majority published during the last decade. The total number of included subjects was 1233. The mean (95% confidence interval (CI)) rate of recurrences was 10.7% (9.1%-12.6%). Eleven studies involving 751 subjects reported the frequency of recurrences separately for primary cases. The mean (95% CI) rate of recurrences was 10.8% (8.7%-13.3%). Five studies reported separately results of surgery for secondary cases. The mean (95% CI) rate of recurrences was 20.0% (12.2%-30.8%). Eight of the sixteen studies reported data on risk factors for recurrence. The use of the Sistrunk technique is a protective factor, whereas children who experienced repeated episodes of infection prior to surgery are exposed to a higher risk of recurrence. CONCLUSION: Recurrences after surgery for TDGCs remain a clinically relevant issue. One of ten operated children experiences a recurrence. Available data support the use of the Sistrunk technique but further studies aimed at improving the clinical management of TDGCs are required.