A Randomized Controlled Trial Of Non Drainage In Children's Thyroglossal Cyst After Operation

Objecive To explore of thyroglossal duct cyst in children after surgery without drainage tube is feasible.Methods:From January 2016 to December 2017,296 children with primary thyroglossal duct cyst in Kunming Children's Hospital were randomly divided into two groups:112 cases were aged less than or equal to 3 years,including 56 cases in drainage group,56 cases in non-drainage group,184 cases over 3 years old,92 cases in drainage group and 92 cases in non-drainage group.The children were similar in age,sex,and surgical methods,the pain scores of 1H,2h,3h,4h,and 48h after the surgery were observed and recorded by the pain score scale(FLACC and VAS),at the same time to observe and record incidence of complications of the postoperative hematoma,incision infection,subcutaneous emphysema,and pharyngeal fistula,hoarseness,difficulty of tongue muscle movement,dysphagia,dyspnea,etc.and to observe and record the incidence of recurrence after six month of surgery to judge after surgery without drainage tube effect.Results:The children were similar in age,sex,and surgical methods.The aged less than or equal to 3 years,the operative time of drainage group and non-drainage group were(63.71 ±4.94)min and(63.86 ±7.61)min(t=0.13,p=0.90),and the size of the cavity was(14.53±3.26)ml;(14.50±3.69)ml(t=0.49,p=0.96).There was no difference between the two groups.But the pain scores at 12 hours,24 hours,48 hours after operation were significantly different(4.46 ± 0.69);(2.36 ± 0.72),(6.54±0.50);(4.29±0.46),(4.29±0.46);(2.39±0.49)(t= 14.47,24.26,34.34P=0.01,0.02,0.0 1),and the time of postoperative hospitalization were also significantly different(7.17±0.70)d,(5.93±0.76)d(t=8.33,P=0.01).The aged over 3 years old,the operative time of drainage group and non-drainage group were(65.07±6.39)min;(64.57±5.15)min(t=0.96,p=0.34),and the size of the cavity was(14.96± 3.16)ml;(14.86±3.70)ml(t=0.30,p=0.77).There was no difference between the two groups.But the pain scores at 12 hours,24 hours,48 hours after operation were significantly different(2.80± 1.41);(2.07± 1.06),(4.72± 1.49);(3.61 ± 1.45),(3.74 ± 0.71);(2.78 ± 0.69)(t = 4.54,5.28,8.94,P =0.01,0.02,0.01),and the time of postoperative hospitalization were also significantly different(7.17±0.70)d,(5.93 ±0.76)d(t=8.33,P=0.01).At the same time,There was no emergency secondary operation in both groups.Postoperative bleeding,hematoma,subcutaneous accumulation of gas,subcutaneous fluid,incision infection,pharyngeal fistula,hoarseness,dyspnea of tongue muscle,dysphagia,dyspnea,dysphonia and postoperative recurrence were not statistically significant.192 cases of children with hearing speech rehabilitation effect,MAIS grading evaluation of GJB2 gene mutations group postoperative score is better than that of control group,the difference was statistically significant(P<0.05),SLC26A4 group follow-up result statistical analysis showed that the evaluation results did not show obvious advantage,mitochondrial 12SrRNA gene mutation group and the control group there was no statistical significance(P>0.05)difference also.CAP classification and grading SIR score,there was no statistically significant difference results between the 5 groups(all P>0.05).Groups of children with preoperative auditory verbal ability scores and boot after postoperative 3,6,9 and 12 months of auditory verbal score difference was statistically significant(P<0.05).Conclusions:Therefore,after the surgery of thyroglossal duct cyst,the drainage tube can not be placed routinely.