Thyroglossal Duct Cyst and Fistula

갑상설관 낭포 및 루

The thyroglossal duct cyst is relatively rare disease that derived congenitally from the remnant of thyroglossal duct and that was found anywhere from the foramen cecum to pyramidal lobe of thyroid. We studied the 62 cases of above disease who admitted and operated at E.N.T. dept. of N.M.C. for 20 years since 1961 to 1980 on the clinical and histopathological aspect, and we concluded following results. 1. In the age distribution, 45 cases(72.6%) were under 20 years, and in the age distribution of the known on-set of symptoms, 26 cases(58.0%) were under 10 years. In the duration, 23 cases(37.0%) were under 1 year. The sex ratio of male to female revealed 1.2:1. 2. The palpable mass were complained at 48 cases(77.4%) and 14 cases(22.6%) complained of the discharge from sinus tracts and the other complaints were dysphagia and odynophagia, etc. 3. In location 55 cases (88.7%) were at midline, 1 case(1.6%) was at right and 6 cases(9.7%) were left sided. And 47 cases(75.8%) were situated at infrahyoid region, 11 cases(17.7%) at suprahyoid, 3 cases(4.8%) at suprasternal, only 1 case(1.6%) at intralingual region. 4. In 27 cases formed fistulae, spontaneous occurrance were 7 cases and artificial occurrance were 20 cases. 5. In histopathologically among 41 cases preserving available slides, 5 cases(12.2%) had single duct and 20 cases(48.8%) had multiple accessory ducts, but 16 cases were impossible to detect the ducts. The lining epithelium composed of chiefly respiratory and squamous epithelium. 15 cases had inflammatory reaction at periductal area and 7 cases had around the cysts. The ectopic thyroid tissue was found on 6 cases(14.6%) and 1 case had the follicular adenoma. 6. In the recurrance rate among 43 cases performed sistrunk type operation, 2 cases (4.6%) recurred, and among 19 cases performed simple removal of cysts, 4 cases (21.1%) recurred.

갑상설관 낭포는 선천적으로 갑상설관의 잔류물에 기인하여 발생하는 비교적 드문 질환의 하나로 설저에서 갑상선에 이르는 갑상설관의 경로중 어디서나 발견된다. 1961연부터 1980연까지 20연간 국립의료원 이비인후과에 입원, 근치수술을 받은바 있는 62례의 환자를 대상으로 임상적 및 병리조직학적 조사결과 다음과 같은 결론을 얻었다. 1) 연령분포상 62례중 20세미만이 45례(72.6%)로 대부분이며, 초기증상 발현시기는 10세미만이 36례(58.0%), 병역기간은 1년미만이 23례(37.0%)로 많고, 남여비는 1.2 : 1이다. 2) 증상은 48례(77.4%)에서 낭포촉지, 14례(22.6%)에서 루관을 통한 분필물, 그 외 연하장애 등이 있었다. 3) 위치는 88.7%가 정중위, 1.6%가 우측위, 9.7%가 좌측위며, 설골직하부가 75.8%, 설골직상부가 17.7%, 음저부가 1.6%, 흉골상부가 4.8%이였다. 4) 루관형성 27례중 생후 자연발생이 7례, 인위적발생이 20례이었다. 5) 병리조직학적으로 조직 Slide가 보존된 41례중 5례(12.2%)에서 단일관, 20례(48.8%)에서 다발성이었고 16례(39.0%)에서 관구조를 발견할 수 없었고, 내면상피는 호흡상피와 편평상피가 주되며, 염증반응은 15례에서 루관주위, 7례에서 낭주위에 보였으며 이행성 갑상선조직은 6례(14.6%)에서 발견되었으며, 1례에서 follicular adenoma가 있었다. 6) 술후재발은 Siskrunk type operation을 한 43례중 2례(4.6%), 단순제거술만 시행한 19례중 4례(21.1%)이었다.