Thyroglossal Duct Cyst
What is a Thyroglossal Duct Cyst?
Thyroglossal duct cyst is a condition where there is a piece of thyroid tissue that is ectopic (ie in the wrong spot), and is usually associated with a lump in the middle of the neck.
Children are usually born with a lump but it becomes more obvious as they grow.
They are thought to occur because the thyroid actually grows from the base of the tongue, and then descends along the thyroglossal tract, down to the front of the neck, right around where you would wear a bow-tie. On it’s way down the neck, a little bit of thyroid tissue gets stuck and is left behind by the migrating thyroid gland.
OUTCOMES
Once a thyroglossal duct cysts is recognised, it is recommended to get it removed. There is a chance it may become infected. This causes pain at first, and then the infection may burst through the skin of the neck and create a chronic oozing sinus.
When a thyroglossal cyst is removed before it has become infected, the recurrence rate is very low (2-5%). After it has been infected, the surgery becomes more difficult and the recurrence rate is between 10 and 20%. Therefore if it is possible, it should be removed before it gets infected.
There is also suggestion in the literature that there is some risk of developing cancer later in life in a thyroglossal cyst, but this is never seen in childhood.
Dr ROB’S APPROACH
Dr Rob will ensure your child has had an ultrasound of your neck, and in particular that they have a normal looking thyroid gland in a normal location, in addition to the cyst.
Dr Rob performs a Sistrunk procedure for thyroglossal duct cysts. In this procedure, an incision is made on the front of the neck, and the cyst is removed along with the tract that travels up through the neck to the base of the tongue. This track travels through the middle of the hyoid bone, so a portion of this bone is removed during the operation as well. Removing a piece of this bone causes no long term issues. This has been shown to have the highest rate of cure.
Once the cyst, tract and bone are removed, the incision is closed with dissolving sutures. If there is concern for bleeding or oozing, then a drain may be left behind. This looks like a skinny plastic tube connected to a small vacuum bell which drains any more blood that might ooze from the edges of the surgery site.
POST OPERATIVE RECOVERY AND CARE
Your child will usually stay in hospital for one night. They will be allowed to eat and drink right away after the operation. If they have a drain, it will usually be removed the next morning. There will be a dressing on their neck that is water resistant, so they will be allowed to shower the next day.
Dr Rob will see you 1 week later in clinic, and if the dressing hasn’t fallen off by then, you can remove it by applying olive oil, or Dr Rob can do it for you in clinic.
DR ROB McCUSKER
Gold Coast Children’s Surgeon
Dr Rob is dedicated to the highest quality of care and technical excellence for his patients.