Thyroglossal Duct Cysts
Thyroglossal duct cysts occur along the embryologic course of the thyroid’s descent from the tuberculum impar of the tongue base to its usual position in the low neck. Although they may occur at any age, they are most common before age 20. They present as a midline neck mass, often just below the hyoid bone, which moves with swallowing. Surgical excision is recommended to prevent recurrent infection. This requires removal of the entire fistulous tract along with the middle portion of the hyoid bone through which many of the fistulas pass. Preoperative evaluation should include a thyroid ultrasound to confirm anatomic position of the thyroid.
A thyroglossal duct cyst occurs when the tissue in your neck doesn’t develop correctly.
Usually, this malformation isn’t painful, though it might be if the area becomes infected. If you have a thyroglossal duct cyst, you may be more likely to develop infections in your neck and throat.
A thyroglossal duct cyst may appear similar to other growths around the neck, including:
- An epidermoid cyst, which is usually closer to the hyoid bone
- A branchial cleft cyst, which usually forms on one side of the neck or the other, but not both
- A bronchogenic cyst, which usually forms on the lower neck
This health problem can cause persistent infections that don’t go away or keep coming back. Your child’s thyroglossal duct cyst is more likely to become infected when they have another infection, like a cold, cough, or sore throat.
A thyroglossal duct cyst is a congenital anomaly, meaning it results from an unexpected change in the womb before birth. Thyroglossal duct cysts occur in both boys and girls. They are not typically associated with any additional congenital anomalies.
If your baby is born with a thyroglossal duct cyst abnormality, the obvious signs include having a small lump or opening on the front of their neck at birth. Other sinus-related symptoms may also appear.
The cyst may be infected if it’s:
- Red in color
- Warm to the touch
- Draining mucus or other liquid internally
A thyroglossal cyst is usually diagnosed when your child’s healthcare provider examines your child. Your child’s healthcare provider will usually recommend that your child see an ear, nose, and throat specialist (ENT). Or the provider may refer you to another healthcare provider with experience in thyroglossal duct cysts. Your child may need tests such as:
- Blood tests. These tests check the thyroid gland function.
- Ultrasound exam. Sound waves are used to check the cyst and thyroid gland.
- CT scan of the neck. X-rays and a computer are used to look at the neck, including the cyst and thyroid gland. Contrast dye is used to get better images.
- Fine needle aspiration. A small needle is used to remove cells from the cyst for diagnosis.
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
Your child’s healthcare provider will regularly check your child’s cyst. Treatment may include:
- Antibiotic medicine
- Cutting into and draining the cyst, if antibiotic medicine doesn’t get rid of the infection
- Cutting out the cyst and some nearby tissue (surgical excision)
- Injecting a substance to remove the cyst, if a child can’t have surgery