Thyroglossal cysts in a pediatric population: apparent differences from adult thyroglossal cysts

BACKGROUND AND OBJECTIVES: The clinical presentation of thyroglossal cyst and its variation from adult thyroglossal cyst has not been well studied. This study is to determine if the clinical presentation of thyroglossal duct cysts (TGDC) varies between children and adults and whether this affects the optimal management of individual cases. DESIGN AND SETTING: Retrospective study of all cases operated on for TGDC from February 2008 to November 2011 in a tertiary care teaching hospital. SUBJECTS AND METHODS: The gender, age, clinical presentation, radiologic imaging, surgical management, postoperative complications, and recurrence rates between the children (≤18 years) and adults (>18 years) were compared. RESULTS: Of the 46 patients, 30 were adults and 16 pediatric; 46.5% of the adults and 74% of the children were females (P=.11). The mean (SD) age in adults was 40.5 (16.0) years, while in children the mean (SD) age was 9.0 (1.4) years, suggesting a bimodal presentation. Hypothyroidism was present in 6.7% of the adults and 56.3% of pediatric cases (P=.0004). Twenty percent of the adults had either an infected TGDC or fistulae, but none of the children had either infection (P=.0001). In both adults and children the duration of disease was significantly shorter in females. In the pediatric group, males had a larger compared to females (P=.006). The most common location of TGDC was the infrahyoid region. The Sistrunk procedure resulted in cure with no recurrences and complications in all. CONCLUSION: TGDC is commoner in adults with no sex predilection. Children have a shorter duration of disease. Male children present with larger cysts. Hypothyroidism is more common in pediatric TGDC. Infected TGDC and fistulae are uncommon in children. The Sistrunk procedure is adequate for both groups.