SEARCH · PubMed Health

Results for “THYROGLOSSAL TRACT”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

120 records · Page 7Linked to original sources

PubMed1993

Thyroglossal duct cysts.

The thyroglossal duct cyst (TGDC) is the most common congenital neck mass and the second most common of all childhood cervical masses. An anterior midline neck mass presenting before the age of twenty and displaying vertical movement with tongue protrusion and swallowing is characteristic of this lesion. Though concomitant agenesis of the thyroid is extremely rare, documentation of a normal thyroid preoperatively has become a legally protective requirement. Carcinoma in a TGDC is unusual and is rarely detected preoperatively, but a fine needle aspiration is helpful if a malignancy is suspected. Regardless, the treatment is a Sistrunk procedure: excision of the cyst, the tract connecting it to the foramen cecum, and the central portion of the hyoid bone.

Adult↗

PubMed2000

Management of neck lumps--a triage model.

We report our experience in the out-patient triage of 100 patients presenting with a lump in the neck. The out-patient visit consisted of a general history and examination, assessment of the upper air and food passages and, where indicated, ultrasound and core needle biopsy of the lump. Other investigations were performed as appropriate. One hundred neck lump patients were seen in a 9 month period. Ninety-six of these lumps were diagnosed on an out-patient basis, only four requiring admission for formal excision biopsy. Among the diagnoses were eleven lymphomas, nine parotid neoplasms, nine lymph node metastases, five thyroglossal cysts, and four branchial cysts. Almost half the patients seen had either a reactive lymphadenopathy, or no abnormality. The establishment of a tissue diagnosis on an out-patient basis allowed appropriate referrals to be made and management plans to be formulated. The theoretical risk of seeding of malignant cells in the needle tract is acknowledged and discussed.

Adolescent↗

PubMedDate not supplied

Thyroglossal duct remnants in infants and children: reevaluation of histopathology and methods for resection.

Established principles for the management of thyroglossal duct remnants have been accepted widely since Sistrunk's description of the operative procedure in 1928. Nevertheless, inadequate excisions and troublesome recurrences still are encountered. We have reviewed 90 infants and children treated at The Children's Hospital in Boston over a 25-year period. Ten patients referred to our institution after an average of 2.4 prior operations per patient elsewhere suffered a recurrence rate of 30% after very wide reexcision. The remaining 80 patients who underwent primary excision at our institution had a 6.3% recurrence rate. All recurrences were managed successfully by further, wider excision. Histologic review demonstrated variability in patterns of drainage of the tract into the oropharynx, with accessory tracts and alveolar outpouchings off the main duct being present in 7.8% of specimens. This study demonstrates that the greatest opportunity for curative resection is at initial presentation, and that previous inadequate or unsuccessful excision is a major risk factor for further recurrence. The variability in microscopic anatomy of thyroglossal duct remnants can account for recurrent disease after lesser procedures, and underscores the importance of wide dissection above the hyoid bone. Our operative methods are illustrated.

Child↗

PubMed1999

Recurrence of a deep neck infection: a clinical indication of an underlying congenital lesion.

OBJECTIVE: To discuss the computed tomographic (CT) and clinical findings of those entities that may present as recurrent deep neck infections. PATIENTS AND METHODS: Twelve patients with recurrent deep neck infections and CT scans were retrospectively identified since 1990. Their CT scans and medical histories were reviewed. The diagnosis was pathologically confirmed in all cases. RESULTS: The CT scans revealed an abscess or a localized infected cyst in the deep soft tissues of the neck, with varying degrees of associated inflammatory change in the adjacent soft tissues. The diagnoses in these cases included 1 first branchial cleft cyst, 3 second branchial cleft cysts, 1 third branchial cleft cyst, 2 fourth branchial cleft cysts, 2 infected lymphangiomas, 2 thyroglossal duct cysts, and 1 cervical thymic cyst. CONCLUSIONS: Most deep neck infections are the result of suppurative adenitis. The location of the primary focus is usually from the mucosa of the upper aerodigestive tract or from an odontogenic source. Less common causes are perforations due to a foreign body, thrombophlebitis of the internal jugular vein, or osteomyelitis of the spine. Recurrences in these situations are unusual. Less commonly, congenital lesions can present as deep neck infections, and recurrences are common. Our cases suggest that the recurrence of a deep neck infection should alert the physician to the possibility of an underlying congenital lesion and that CT is helpful in the early recognition of these lesions.

Adolescent↗

PubMed1989

Sistrunk revisited: a 10-year review of revision thyroglossal duct surgery at Toronto's Hospital for Sick Children.

The definitive surgical management of thyroglossal duct cysts (TGDC) was elucidated by Sistrunk in 1920. However, the procedure is often poorly performed. We reviewed the charts of 143 patients managed for TGDC at the Hospital for Sick Children. Toronto, between 1978-1988. These patients underwent 214 surgical procedures at HSC and elsewhere for cure. One hundred and five patients needed only one procedure. Thirty-eight patients had recurrent disease. These needed 109 procedures for cure. Inadequate surgery was the direct cause of recurrence. Areas of surgical failure included misdiagnosis, inadequate hyoid bone resection and persistent infra or suprahyoid tract remnants. Representative case samples are outlined with clinical, surgical and pathologic correlation. We recommend performing the complete, classic Sistrunk procedure for all cases of TGDC.

Abscess↗

PubMed1989

Unusual patterns of congenital neck masses in children.

Congenital neck masses--thyroglossal duct cysts (TDC) and branchial cleft cysts (BCC)--are frequently encountered in any pediatric surgical practice. While their diagnosis is usually straightforward, unusual or combined presentations may occur. We report eleven cases of unusual patterns of congenital neck masses in children. Two patients underwent resection of a BCC with a sinus tract extending through the carotid bifurcation. Both patients subsequently presented with a new mass near the previous scar, which was thought to be a recurrence but was found at surgery to have TDCs with sinus tracts extending through the hyoid bone. In one patient, a lateral neck mass (presumed to be a BCC) was found at surgery to be a TDC. In all three cases the diagnoses were confirmed histologically. Eight patients presented with a solitary thyroid nodule. Six of these had intrathyroid branchial cleft remnants, and two had intrathyroid TDCs. The diagnosis became apparent at operation in six patients, while in two it was made by the pathologist after hemithyroidectomy. Ages at presentation ranged from 16 months to 14 years. The embryology of these neck structures is closely related. It should not come as a surprise that errors in their development may occur, at times paralleling the occurrence of intrathyroid location of parathyroid glands. The possibility of an embryologic rest in the neck should therefore be kept in mind with all clinically evident neck masses. TDCs and BCCs may coexist in the same patient. The histologic differentiation may be difficult in the presence of inflammation, but differences in structure are often characteristic.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1993

Case report: lingual thyroid, a cause of neonatal stridor.

Stridor implies partial airway obstruction, resulting from intrinsic or extrinsic abnormalities of the upper respiratory tract. In a neonate whose airway is small, soft and easily occluded this may be potentially life threatening. Its immediate diagnosis with prompt therapy is a rewarding challenge. When stridor occurs in a neonate with congenital hypothyroidism, surgically amenable cause of obstruction due to an ectopic thyroid or thyroglossal cyst has to be seriously considered. We report a case of neonatal stridor caused by a lingual thyroid, and discuss the imaging approach.

Congenital Hypothyroidism↗

PubMed2000

Sonographic evaluation of thyroglossal duct cysts in children.

BACKGROUND AND AIMS: Thyroglossal duct cysts (TDC) in children have a variable sonographic appearance. Some reports have suggested that TDCs appear on ultrasound as well defined, cystic masses with thin walls and posterior enhancement, whereas others have documented a heterogeneous echopattern within these lesions. In our experience, although TDCs in children have a variable ultrasound appearance, the most common appearance is that of a pseudosolid mass closely related to the hyoid bone. In this study we report on 23 patients with thyroglossal duct cysts and document the ultrasonic patterns. PATIENTS AND METHODS: All patients in whom the diagnosis of TDC was made clinically (by at least two head and neck surgeons) and in whom ultrasound detected a cystic mass related to the hyoid bone, were included in this study. Sonograms of 23 children with TDCs were reviewed. The features evaluated included their location, internal echogenicity, posterior enhancement, the presence of septa, a solid component and a fistulous tract. The echopattern was not correlated with the biopsy results. RESULTS: Three patterns of TDCs were identified: anechoic (13%); pseudosolid (56.5%); and a heterogeneous pattern (30.5%). The majority were midline (82.6%), showed posterior enhancement (56.5%), and had thin walls (82.6%). CONCLUSION: On ultrasound, TDCs in children are not simple cysts but have a complex pattern ranging from a typical anechoic cyst to a pseudosolid appearance (most common).Ahuja, A. T. (2000). Clinical Radiology55, 770-774.

Adolescent↗

PubMed2005

[Skin and soft tissue infections caused by Haemophilus influenzae type b over a 30 year period].

INTRODUCTION: The skin and soft tissue infections caused by Haemophilus influenzae type b (Hib) are usually mild but can be potentially serious due to the high probability of bacteremia. Prompt instauration of empiric intravenous antibiotic therapy according to the localization and characteristics of the lesion is mandatory to prevent severe complications. PATIENTS AND METHODS: Of 257 children admitted to the Children's Hospital of La Fe due to invasive Haemophilus influenzae type b disease (1973 to 2003), we reviewed 15 cases (5.8%) of skin and soft tissue infections, their outcome, complications and sequelae. RESULTS: Ten children (66.7%) were aged < 2 years old. In eight patients (53.3%) there was a history of upper respiratory tract infection. Localization was in the head in 9 children (60%) and blood culture was positive in 10 patients (66.7%). Meningitis was a complication in 2 children (13.3%) and limited mobility of the hand was a sequel in one child (6.6%). After the universal establishment of the Hib vaccine in 1997, 3 new patients were admitted; 2 children with an infected thyroglossal cyst and another with cellulitis in the left leg. Of these children, one had received only the three primary doses of the vaccine but not the booster dose, and the remaining two were unvaccinated immigrant children. CONCLUSION: Skin and soft tissue infections caused by Hib are potentially severe diseases with a risk of complications and sequelae. Due to the increase in unvaccinated immigrants and possible vaccine failures, universal immunization and epidemiological surveillance of carriers should be carried out to achieve total eradication.

Child↗

PubMed1999

Thyroglossal duct cysts: sonographic appearances in adults.

BACKGROUND AND PURPOSE: Previous reports have suggested that thyroglossal duct cysts (TDCs) appear on sonograms as well-defined cystic masses with thin walls and posterior enhancement. In our experience, however, TDCs have a variable sonographic appearance. We report our findings in 40 patients with TDCs and document the variability of sonographic patterns. METHODS: All patients in whom the diagnosis of TDC was made clinically (by at least two head and neck surgeons) and sonography detected a cystic mass related to the hyoid bone were included in this study. Sonograms of 40 patients with TDCs were reviewed. The features evaluated were the location, internal echogenicity, posterior enhancement, presence of septa, solid component, and fistulous tract. The echo pattern was not compared with the biopsy results. RESULTS: Four patterns of TDCs were identified: anechoic (28%), homogeneously hypoechoic with internal debris (18%), pseudosolid (28%), and heterogeneous (28%). The majority showed posterior enhancement (88%), were midline (63%), and infrahyoid in location (83%). Only half of all TDCs showed a typical thin wall. CONCLUSION: On sonograms, TDCs in adults are not simple cysts, as previously suggested, but have a complex pattern ranging from a typical anechoic to a pseudosolid appearance.

Adult↗

PubMed1997

Cervical chrondrocutaneous branchial remnants.

Similar in appearance to preauricular tags but located in the lateral neck, cervical chondrocutaneous branchial remnants are a rather less common and less well known congenital lesion. A retrospective review of admissions at Sainte-Justine Hospital between 1980 and 1993 produced 20 cases of cervical tags, of which 17 were true cervical chrondrocutaneous branchial remnants and 3 were skin tags associated with a thyroglossal duct. Of the 17 true cervical chrondrocutaneous branchial remnants, 15 were operated on in our institution. The clinical characteristics, results of investigations, surgical data, pathologic findings, and associated anomalies were documented. Several interesting facts emerged, including a male predominance (11 of 17), a scarcity of bilateral lesions (1 of 17), the presence of an elastic cartilage core in all operated specimens (15 of 15), and a high incidence of associated anomalies (13 of 17). We suggest that the second branchial arch is the most likely origin for the lesion. We propose a clear, widely acceptable name for this anomaly in order to prevent further diagnostic confusion. Most important, although simple surgical excision is all that is required for treatment, a complete physical examination of the patient and possibly an ultrasound examination of the genitourinary tract are recommended because a cervical chrondrocutaneous branchial remnant has proven in many cases to be a visible "marker" for more serious associated anomalies.

Abnormalities, Multiple↗

PubMed2000

The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings.

Thyroid imaging approach is based on the preliminary clinical evaluation. Lesions that are smaller than 2 cm should be assessed with US, which is capable of discriminating masses as small as 2 mm and distinguishing solid from cystic nodules. US-guided FNAB provides tissue for cytologic examination of thyroid nodules. CT and MR imaging are indicated for larger tumors (greater than 3 cm diameter) that extend outside the gland to adjoining structures, including the mediastinum, and retropharyngeal region. Metastatic lymph nodes in the neck and invasion of the aerodigestive tract are also in the realm of CT and MR imaging. Thyroid nodules are categorized on scintigraphy as hot or cold nodules. Hot nodules are rarely malignant, whereas cold nodules have an incidence of 10% to 20% of malignancy. Calcifications (amorphous, globular, nodular, and linear) occur in adenomas and carcinomas and have no differential diagnostic features except for psammomatous calcifications, which are a pathognomonic finding in papillary carcinomas and a small percentage of medullary carcinomas. Papillary carcinoma is the most common malignant tumor (80%) followed by follicular (20% to 25%); medullary (5%); undifferentiated; anaplastic carcinomas (< 5%); lymphoma (5%); and metastases. Lymph node metastases are common in papillary carcinoma, 50% at presentation, and less common in follicular carcinomas. The metastatic nodes in papillary carcinoma may enhance markedly (hypervascular); show increased signal intensity on T1-weighted images (increased thyroglobulin content or hemorrhage); and reveal punctate calcifications. Localized invasion of the larynx, trachea, and esophagus occurs predominantly in papillary and follicular carcinomas; the incidence is less than 5%. Ectopic thyroid tissue may be encountered in the tongue (foramen cecum); along the midline between posterior tongue and isthmus of thyroid gland; lateral neck; mediastinum; and oral cavity. Goiter and malignant tumors, notably papillary carcinoma, may develop in ectopic thyroid tissue. Carcinomas may also arise in thyroglossal duct cysts, which develop from duct remnants between the foramen cecum and thyroid isthmus. Infectious disease of the thyroid gland is not common and the CT and MR imaging findings are similar as described under neck infection. Other types of inflammatory disorders including Hashimoto's thyroiditis, granulomatous thyroiditis, and Riedel's struma display no specific imaging features. Imaging studies may, however, be indicated to confirm a suspected clinical diagnosis and assess compromise of the airway (Riedel's struma). HPT is a clinical diagnosis in which hypercalcemia is the most important finding. Parathyroid hyperplasia, adenoma, and carcinoma represent underlying lesions. To relieve the patient's symptoms surgical extirpation is indicated. The surgical success rate without imaging is 95%. The indications for imaging studies vary but it is generally agreed that reoperation after a previous failed surgical attempt and suspicion of an ectopic parathyroid adenoma should be investigated by imaging. These consist of US, nuclear medicine studies, CT and MR imaging. US and technetium sestamibi scanning have the highest accuracy rate for localizing an adenomatous gland at and near the thyroid gland. Ectopic adenomas, particularly if they are located in the mediastinum, are preferrably investigated with CT and MR imaging with gadolinium and fat suppression. Carcinomas and parathyroid cysts are optimally evaluated by CT and MR imaging. On MR imaging adenomas are low in signal intensity on T1-weighted images, high in signal intensity on T2-weighted images, and enhance post introduction of gadolinium.

Carcinoma↗