METHODS: Expert recommendations on the diagnosis, management, surgical and post-operative considerations for TGDC were established through a multi-iterative Delphi-consensus survey of pediatric otolaryngologists.
RESULTS: The survey participants included 33 pediatric otolaryngologists from 18 different countries. The consensus recommendations are as follows: 1) ultrasound is the preferred diagnostic imaging modality, with cross-sectional imaging considered in the setting of an uncertain or complicated clinical presentation; 2) an open trans-cervical approach with removal of the central hyoid bone; 3) intra- and post-operative administration of antibiotics in the setting of active TGDC infection; 4) post-operative admission in patients with comorbidities or if a drain is employed.
CONCLUSION: Consensus was achieved for several diagnostic and surgical considerations in the management of children with TGDC. As there remains variability in opinion on other aspects of management, clinicians may need to provide a nuanced approach in the context of individual patient factors and institutional circumstances.