# Comparative Analysis of Surgical and Conservative Approaches to Recurrent Thyroglossal Duct Cysts: A Literature Review

## TL;DR

This review compares surgical and non-surgical treatments for recurring thyroglossal duct cysts, finding that conservative methods may offer benefits but surgery remains the standard due to proven effectiveness.

## Contribution

The study provides a comparative analysis of treatment options for recurrent thyroglossal duct cysts, highlighting the potential and limitations of conservative approaches.

## Key findings

- Nine studies involving 278 patients were analyzed, with 143 undergoing surgery and 135 receiving chemical ablation.
- Conservative treatments showed potential benefits like lower recurrence rates and faster recovery, but surgery remains the preferred method due to its proven efficacy.
- Ethanol and OK-432 were the primary agents used in chemical ablation for this condition.

## Abstract

Introduction
 The management of recurrent thyroglossal duct cysts poses persistent challenges. The present review assesses chemical ablations and surgical re-interventions as strategies for recurrence. However, limited comparative studies exist to determine the optimal approach and follow-up outcome.

Objectives
 The aim of the current study is to conduct a review gathering evidence from the literature to analyze and synthesize the safest and most effective approaches for treating recurrent thyroglossal duct cysts.

Methods
 The present study aims to comprehensively search electronic databases, including the Latin American and Caribbean Literature in Health Sciences (Literatura Latino-Americana e do Caribe em Ciências da Saúde, LILACS, in Portuguese), the database of the
Journal of the American Medical Association
(JAMA), SciVerse Scopus, Virtual Health Library (Biblioteca Virtual em Saúde, BVS, in Portuguese), and PubMed, for articles on recurrent thyroglossal duct cysts. The selected articles include patients with recurrent cysts, cover publications from 2000 to 2022, describe clinical and/or surgical interventions, and ensure the safety and efficacy of the analyzed approach.

Results
 The present review included 9 studies, involving a cohort of 278 patients. Out of these patients, 143 underwent surgical interventions and 135 underwent chemical ablations (82 using ethanol and 53 with OK-432).

Conclusion
 Conservative management of recurrent thyroglossal duct cysts is a growing trend, albeit requiring further refinements. This approach presents potential advantages, including decreased recurrence rates, shorter surgical duration, cost-effectiveness, and expedited recovery. Nevertheless, surgical intervention remains the preferred therapeutic choice owing to its established efficacy and widespread familiarity. The projected therapeutic approach shifts for thyroglossal duct cysts as conservative treatment gains substantiated benefits.

Systematic Review Registration
: The International Prospective Register of Systematic Reviews (PROSPERO) does not accept scoping reviews, literature reviews, or mapping reviews.