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Chemical ablation using ethanol or OK-432 for the treatment of thyroglossal duct cysts: a systematic review and meta-analysis

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Abstract

Objectives

To review the effectiveness and safety of chemical ablation using ethanol or OK-432 for the treatment of TGDCs (thyroglossal duct cysts).

Methods

MEDLINE and EMBASE databases were searched up to May 29, 2020, to identify studies reporting the safety and efficacy of chemical ablation using ethanol or OK-432 for the treatment of TGDCs. The search query consisted of synonyms of thyroglossal duct cysts and ethanol or OK-432 ablation. The pooled success and complication rates were calculated using the inverse variance method to calculate weights, and pooled proportions were determined using the DerSimonian-Laird random-effects method.

Results

Seven original articles including a total of 129 patients were included. The efficacy of chemical ablation was acceptable, with a pooled success rate of 70% (95% CI, 47–86%). The pooled success rate of ethanol ablation was superior to that of OK-432 ablation, although with equivocal statistical significance (84% vs. 51%, p = 0.055). Repeat ethanol ablation achieved a pooled success rate of 47% (95% CI, 24–71%). The chemical ablation procedures were safe, with a pooled major complication rate of 0.9% (95% CI, 0.1–5.8%).

Conclusions

Chemical ablation using ethanol or OK-432 for the treatment of TGDCs had acceptable success and low complication rates, and repeat treatment after initial failure was also feasible. In addition, it is an inexpensive and simple procedure and could therefore be considered a first-line treatment for TGDCs.

Key Points

• The efficacy of chemical ablation using ethanol or OK-432 was acceptable, with a pooled success rate of 70% (95% CI, 47–86%). The pooled success rate of ethanol ablation was superior to that of OK-432 ablation, although with equivocal statistical significance (84% vs. 51%, p = 0.055).

• Repeat ethanol ablation was also feasible, with a pooled success rate of 47% (95% CI, 24–71%).

• The chemical ablation procedures were safe, with a pooled major complication rate of 0.9% (95% CI, 0.1–5.8%).

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Abbreviations

G:

Gauge

KE:

Klinische Einheit (clinical unit)

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

RoBANS:

Risk of bias for nonrandomized studies

TGDC:

Thyroglossal duct cyst

US:

Ultrasound

VRR:

Volume reduction ratio

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-735, Korea

    Sang Ik Park, Jung Hwan Baek, Chong Hyun Suh, Sae Rom Chung, Young Jun Choi & Jeong Hyun Lee

  2. Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-735, Korea

    Tae Yong Kim

  3. Division of Endocrine Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-735, Korea

    Yu-Mi Lee

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  1. Sang Ik Park
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Correspondence to Jung Hwan Baek.

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The scientific guarantor of this publication is Jung Hwan Baek.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (Chong Hyun Suh) has significant statistical expertise.

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Written informed consent was not required for this study because it was a systematic review and meta-analysis using data from published studies.

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Institutional Review Board approval was not required because this study was a systematic review and meta-analysis using data from published studies.

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• Retrospective

• Multicenter study

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Park, S.I., Baek, J.H., Suh, C.H. et al. Chemical ablation using ethanol or OK-432 for the treatment of thyroglossal duct cysts: a systematic review and meta-analysis. Eur Radiol 31, 9048–9056 (2021). https://doi.org/10.1007/s00330-021-08033-2

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  • DOI: https://doi.org/10.1007/s00330-021-08033-2

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