Management of recurrent thyroglossal duct cysts.

In a review of 141 patients with thyroglossal duct cysts between 1961 and 1981, 28 patients were found to have surgical treatment for recurrent cysts and sinuses. Recurrent disease following surgical failure results in a high incidence of fistula formation. In the operative treatment of recurrent disease, all patients had a segment of hyoid bone excised. The dissection was extended to include a core of the base of the tongue in 20 of the 28 patients. There have been no surgical failures in this population of patients treated for recurrent thyroglossal duct cysts. We are currently treating patients with recurrent cysts and sinuses with en bloc anterior neck dissections, a modification of the classic Sistrunk procedure.