Reoperation for cysts of the thyroglossal duct

To determine the causes of recurrence of thyroglossal duct cysts (TDCs). A case series. A university-affiliated children's hospital. Between 1974 and 1990, 121 children were treated for TDCs. They ranged in age from 1 month to 18 years. Of these 121 children, 23 had recurrent TDC. Simple aspiration of the cyst, incision and drainage, cystectomy without hyoidectomy and the Sistrunk operation. Initial procedures that led to recurrence and procedures that resulted in cure. Six children had recurrence of TDCs after simple cystectomy without hyoidectomy; all were cured by the Sistrunk operation. Fourteen children with infected cysts initially underwent a variety of procedures with recurrence and were eventually managed by the Sistrunk operation. TDCs recurred in eight of these. Three children without infected cysts had recurrence after the Sistrunk operation. Of 34 TDCs infected initially, 40% recurred, whereas of 87 TDCs that were not infected initially, only 8% recurred. Simple cystectomy without hyoidectomy and pre-existing infection are the main causes of recurrence of TDCs.