Thyroglossal Duct Cyst

The thyroid gland originates at the base of the tongue in infancy. It actually migrates from that location, down the from of the neck though a narrow stalk, known as the thyroglossal duct, which subsequently disintegrates as a person ages. In some cases the lumen of this temporary tract remains and then forms either into an ectopic thyroid and/or persistent thyroglossal duct or cyst form if thyroid descent is abnormal.

These cysts are the most common anomaly in thyroid development and occur equally in males and females. They are seen at birth in about 25% of cases; most appear in early childhood; and the rest, about one third, become found only after age 30 years. Cysts usually appear in the mid line portion of the neck or just off the midline between the isthmus of the thyroid and the hyoid bone. Patients may notice a tender or enlarging lump in the central part of the from of the neck. They can become infected or rupture.. Removal of a thyroglossal cyst or fistula requires a surgical procedure known as "the Sistrunk procedure" to excise the central part of the hyoid bone and dissect the thyroglossal tract to the base of the tongue. This procedure is necessary because the thyroglossal duct is closely associated with the central part of the hyoid bone. Recurrent cysts are very common if this operative procedure is not completed. Another complication is formation of papillary thyroid cancer within the cyst.