Thyroglossal duct cysts (TGDCs) are the most common congenital anomaly of the neck. The most common presentation of TGDCs is a firm, midline mass. The Sistrunk procedure is the recommended treatment for TGDCs. Based on anatomic and embryologic study, Dr. Sistrunk recommended removal of not only the cyst and central portion of the hyoid bone, but also a central core of deep tongue musculature. By doing so, the rate of recurrence is decreased from approximately 50 to 3-5%. In this chapter, the authors will describe the Sistrunk procedure step by step including surgical pearls for success.
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