What is a thyroglossal duct cyst?

A thyroglossal duct cyst is a neck swelling in the anterior part filled with fluid. The thyroid gland starts at the tongue's base as a baby grows in the uterus. During infancy, the thyroid gland migrates in the neck to its typical location under the thyroid cartilage and above the sternum. Part of this tract, where the thyroid gland migrates, can become filled with mucus-like fluid, forming a thyroglossal duct cyst.

What are the symptoms of thyroglossal duct cysts?

If you or your child has a thyroglossal duct cyst, you may first become aware of the cyst because there's a lump on your or your child's throat that goes up when you or your child swallows. You also might notice a cyst when you or your child pokes out their tongue. Occasionally, doctors find these cysts during a physical exam for another purpose. Other symptoms are:

• Thyroglossal duct cysts are palpable. If you press on one, it will feel smooth, soft, and round, similar to a small ball of cookie dough.
• Thyroglossal duct cysts can become swollen and painful if you or your child has an upper respiratory tract infection that becomes infected and spreads to the cyst.
• Thyroglossal duct cysts can rupture, leaking fluid through your or your child's skin.

These cysts can make it difficult to swallow food or liquids.

What causes thyroglossal duct cysts?

These cysts form during pregnancy when your body starts constructing your thyroid gland. That's the butterfly-shaped gland that produces hormones that regulate your metabolism. Metabolism is the rate at which your body processes things (how quickly it burns food to create energy and heat).

To form the gland, thyroid cells migrate from the bottom of your tongue to your hyoid bone. That's a U-shaped bone that holds up your tongue. Thyroid cells migrate through what's known as the thyroglossal tract. Usually, this tract closes and disappears after your thyroid glands are formed. But tracts that don't close can become filled with fluid and mucus and turn into thyroglossal cysts. Scientists are not sure why the tracts of some individuals do not dissolve.

How is a thyroglossal duct cyst diagnosed?

A thyroglossal duct cyst is usually first found when a physician or the family notices a mass in the upper midline neck in a child with no other symptoms.

Because the neck can contain a wide range of different masses, an imaging study must be done. Most commonly, this study is a cervical ultrasound, but at times, a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan may be ordered.

The imaging is done to check if the mass is cystic and not solid and to document the fact that there is a normal thyroid gland in the lower neck. A solid neck mass with no distal thyroid gland is suspicious for a so-called "ectopic thyroid," where the neck mass is all the child's thyroid tissue. This is rare, but fortunately so.

Several other congenital cystic neck masses may mimic a thyroglossal duct cyst, the most frequent one being a dermoid cyst. Even a dermoid cyst cannot always be differentiated from a thyroglossal duct cyst based on physical examination and imaging tests, and the diagnosis is not clear until the mass is excised and examined by a pathologist.

How is a thyroglossal duct cyst treated?

Surgical excision is the treatment of choice for thyroglossal duct cysts. There is no current known medical treatment apart from infected thyroglossal duct cysts, where an immediate course of antibiotics must be taken. Any infection should first be eradicated before operating. It has long been known that the excision of a thyroglossal duct cyst before infection will achieve a more successful result than cyst excision after past infection.

Surgical intervention not only involves the removal of the cyst but also its possible attachment to the base of the tongue so that recurrence does not occur. This involves excision of the central section of the hyoid bone, as this attachment may be anterior (in front of), posterior (at the back of), or indeed within the bone itself. This is referred to as a Sistrunk procedure. The recurrence rate is as high as 50 per cent if the central part of the hyoid bone is not excised.

The complications of the Sistrunk procedure are those that are usual for any open neck procedure, like hematoma, seroma, or infection after the operation. Removal of the central part of the hyoid bone does not negatively impact the child's swallowing or speech.

Recurrence of a thyroglossal duct cyst is possible even after an appropriate Sistrunk procedure has been done. This is more likely if the cyst was previously infected.

Can thyroglossal duct cysts be avoided?

Thyroglossal duct cysts are present at birth, which means individuals are born with the cysts.

What happens when my child has a thyroglossal duct cyst?

In most cases, cysts taken out with Sistrunk surgery do not recur, effectively treating the condition.

What can I expect if I have cancer of a thyroglossal duct cyst?

Research indicates that surgery cures 95% of the thyroglossal duct cyst cancers. Some individuals will receive radioactive iodine treatment following surgery.

What questions should I ask my doctor?

Thyroglossal duct cysts are uncommon, so you might be astonished to discover that your child has one. If you have a cancerous thyroglossal duct cyst, you'll have questions for your doctor as well. Here are some tips for that discussion:

• What is a thyroglossal duct cyst?
• Why did I/my child get one?
• Will I/my child require surgery?
• If I have/my child has surgery, can the cyst recur?
• My cyst is malignant. What should I have done?
• What are the treatment side effects?

Why Tender Palm Super-Speciality Hospital for thyroglossal duct cyst treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers thyroglossal duct cyst treatment in Lucknow, India. We have a skilled team of ENT surgeons experienced in performing the Sistrunk procedure with high success and low recurrence. Using advanced imaging and surgical techniques, we ensure precise diagnosis, safe cyst removal, and fast recovery.

To seek an expert consultation for thyroglossal duct cyst treatment in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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