Abstract:

Objective To diagnose thyroglossal duct cysts (TDCs) in anterior cervical region in children based on imaging findings and clinical physical examnination. Methods Forty-nine patients with suspected congenital midline cervical anomalies in anterior cervical region and with radiologic images before surgery were categorized into TDCs group and non-TDCs group depending on their histopathologic diagnosis from September 2012 to October 2014. Comparative study was performed between the two groups with following 6 indicators: movement of cysts with deglutition and protrusion of the tongue ,the location of cysts in CT and MRI,close proximity to the hyoid bone,relationship to the midline, density and size.Then the sensitivity,specificity,false positive ratio,positive predictive value,negative predictive value and 95%CI of single or combined indicators with statistical differences were evaluated. Results Of the 49 pediatric patients,32 patients［(3.9±2.7) years old,19 boys］ had histopathologically confirmed as TDCs. Other 17 patients［(5.2±3.0) years old,7 boys］ had epidermoid cysts(n=9),dermoid cysts (n=4),teratoid cyst (n=1),ranula (n=1), and cystic lymphangioma (n=2). ①Single factor analysis showed there were statistically significant differences in movements with deglutition and protrusion of the tongue, the location and relationship to the hyoid bone of cysts between the two groups. There were no statistical differences in relationship to the midline and size of masses between the two groups. ②The sensitivities of each 3 indicators (cysts moving with deglutition and protrusion of tongue,cysts in close promixity to hyoid bone, cysts located in submandibular region) were 75.0%,65.6%,68.8% respectively, and specificities were 70.6%,94.1%,82.4% respectively for TDCs. The sensitivity and specificity of any one of these 3 indicators were 93.8%,29.4% respectively for TDCs.The sensitivity and specificity of all these 3 indicators were 0%,100% respectively for TDCs .The sensitivity and specificity of any one of these 2 indicators(cysts in close promixity to hyoid bone, cysts located in submandibular region) were 84.4%,82.4% respectively. Conclusion It is very useful to diagnose TDCs in anterior cervical region with clinical physical examination and radiologic imaging in chilidren.