Thyroglossal cyst is a well recognised congenital malformation that occurs in 7% of the population. Thyroglossal duct cysts tgdcs are the most common form of congenital cyst in the neck. The rupture of the thyroglossal cyst, or the incomplete removal of the thyroglossal cyst during the time of the surgery, results in the formation of a. Thyroglossal duct cyst surgery sistrunk procedure ent. Papillary thyroid carcinoma in the epithelium of the cyst is a rare but. Management of recurrent thyroglossal duct cysts jama. A thyroglossal duct cyst has a small chance of regrowing if small portions of the tissue remain after surgery.
Malignancy in a thyroglossal duct cyst is rare, the incidence being less than 1%. It is the most common type of nonodontogenic cyst i. Thyroglossal duct cyst excision iowa head and neck protocols. We report our findings in 40 patients with tdcs and document the variability of. It can also provide preoperative information regarding the presence or absence of a solid component within the cyst. Thyroid gland and surgery of the thyroglossal duct.
The thyroglossal duct represents the tract in the midline neck through which the thyroid anlage descends during embryonic development. Thyroglossal duct cysts result from an error in the formation of the thyroid gland. The cyst andor fistula are located between the base of the tongue and the thyroid gland, predominantly adjacent to the hyoid bone. The thyroid cyst usually arises within the midline this midline location being an important diagnostic characteristic, presenting as a round, smooth, nontender mass on palpation but can be painful and tender, if infected. Surgical removal of the cyst and the thyroglossal duct, called the sistrunk procedure. Occasionally the cyst will appear with an infection present resulting in redness, increased swelling and tenderness. A thyroglossal cyst is a fibrous cyst that forms from a persistent thyroglossal duct. Apart from being a quiescent embryological remnant, it presents itself clinically at any age and often requires surgical excision. Pdf thyroglossal duct cystmore than just an embryological. Although treatment involves surgical excision, few large. The epithelial lining of the cyst varies with location. Thyroglossal cyst is an abnormal growth on the neck that looks like a lump. It most often presents with a soft swelling under the chin which moves with swallowing. The surgical treatment of cysts of the thyroglossal tract.
A decade of experience of thyroglossal cyst excision. Thyroglossal cyst removal surgery with complications part 1 here and others to come. Removal of thyroglossal duct cyst sistrunk procedure childrens. In this chapter, the authors will describe the sistrunk procedure step by step including surgical pearls for success. A thyroglossal duct cyst is a pocket filled with fluid in the front part of neck. The excision of the body of the hyoid bone helps in excision of any retro hyoid part of the thyroglossal tract and also complete excision of the thyroglossal tract up to the foramen caecum. This could be done in the office under local anesthesia.
They result from failure of normal developmental obliteration of the thyroglossal duct during development 8 th 10 th gestational week and can thus occur anywhere along the course of the duct. During this time, a group of cells at the base of the babys tongue move down a canal. Rarely, thyroid cancer can occur inside a thyroglossal duct cyst and may require further surgical treatment. Following the surgery, the patient is transported to the recovery room where they are observed for approximately an hour.
Thyroglossal duct cyst in children health encyclopedia. Fortyfour children oct 19, 2017 a thyroglossal duct cyst is a fluidfilled pocket in the front of the neck, just above the voice box. A thyroglossal duct cyst has a small chance of regrowing if small portions of the tissues remain after surgery. Noscar transoral thyroglossal duct cyst excision in. When a diagnosis of a thyroglossal cyst carcinoma is made, an evaluation of the thyroid gland during surgery must be done as well as a careful. Thyroglossal duct cysts tgdc are the most common congenital cysts in the neck 1, 2. Clinically, no differentiation between a benign cyst and a malignancy can be made. Thyroglossal cyst differential diagnosis and complications. Mar 07, 2011 thyroglossal cyst is an abnormal growth on the neck that looks like a lump. The role of imaging is to confirm the clinical diagnosis and identify the presence of the thyroid gland.
The thyroglossal duct cyst must be studied in the adult population through fineneedle aspiration biopsy fnab and a frozen section in cases in which fnab is inconclusive or unavailable. Thyroglossal cyst an overview sciencedirect topics. A thyroglossal duct cyst is a fluidfilled pocket in the front of the neck, just above the voice box. Jun 25, 2016 the technique for cyst removal shown in this video is the sistrunk procedure, which is the most commonly preformed procedure for thyroglossal cyst excision. Thyroglossal duct cysts tdcs are diagnosed clinically. A minimally invasive transoral removal of the mass was performed under the assistance of the endoscopic system. Thyroglossal duct cyst pictures, symptoms, treatment, removal. A thyroglossal duct cyst happens when your thyroid, a large gland in your neck that produces hormones, leaves behind extra cells while its forming during your development in. May 08, 2015 thyroglossal duct cyst with intralaryngeal extension. Thyroglossal duct carcinoma is a rare pathologic entity. Surgical removal is recommended following an episode of infection, as infection tends to recur. Some of the patients were subsequently treated with radioactive iodine therapy 67 % of them. Doctor answers on symptoms, diagnosis, treatment, and more.
Key points about a thyroglossal duct cyst in children. Objective to determine the utility of ultrasonography as a sole diagnostic study in the preoperative preparation of patients with presumed thyroglossal duct cysts. This cyst may also occur in the lingual or submental areas, though more rarely. These types of cysts can form from leftover tissue during the development of the thyroid gland before a baby is born. A rapid increase in growth or the presence of a firm, palpable mass may be signs of malignancy. Thyroglossal duct cyst is the most common cause of congenital neck swelling. The thyroglossal duct attached to the cyst is dissected upwards. Lying in bed too much keeps your lungs from expanding fully. A thyroglossal duct cyst of the anterior mediastinum.
Adenosquamous carcinoma arising in a thyroglossal duct cyst. Dec 27, 2017 thyroglossal cyst removal surgery with complications part 1 here and others to come. It begins at the foramen cecum at the base of the tongue, continues around the hyoid bone, and ends at the normal position of the thyroid gland in the pretracheal lower neck. Settings childrens memorial hospital, chicago, ill. Indications it is indicated to remove all thyroglossal duct cysts, ideally before they become infected as infection is associated with a higher rate of recurrence. This operation involves removing a congenital cyst from the neck. Huge thyroglossal duct cyst at the suprasternal notch.
Thyroglossal duct cyst patient education page 2 pneumonia. A thyroglossal duct cyst is a mucous filled sac located in the midline of the neck. The operation that has been recommended is called a sistrunk procedure for the excision of a thyroglossal duct cyst tgdc. Surgery and complete excision is the main treatment and the optimal patient management includes multidisciplinary consultation in order to improve survival.
Risks and complications of thyroglossal duct cyst removal. A thyroglossal duct cyst is a pocket in the front part of neck that is filled with fluid. Because the embryonic hyoid bone forms around the thyroglossal duct, it is important to remove the body of the hyoid along with the thyroglossal duct and follow it to the foramen caecum at the base of the tongue sistrunk procedure. Recurrent disease following surgical failure results in a high incidence of fistula formation. A congenital neck cyst is a mass that is present at birth. Postoperative instructions for a thyroglossal duct cyst. Yamada s, noguchi h, nabeshima a, tasaki t, kitada s, guo x, et al. Alternative treatments for thyroglossal duct cyst things. Sep 26, 2017 a thyroglossal duct cyst happens when your thyroid, a large gland in your neck that produces hormones, leaves behind extra cells while its forming during your development in the womb. Thyroglossal duct cyst a lump found in the midline of the neck that was part of a structure. Infection of the cyst prior to surgery can make the removal more difficult and increase the chance for regrowth.
As thyroglossal cysts are a birth defect, there is no preventive strategy in avoiding the occurrence of this condition in a person. A thyroglossal cyst is also known as a thyroglossal duct cyst or thyroglossal tract cyst. Operative techniques in otolaryngology head and neck surgery volume 20, issue 4, pages 256259, december 2009 vm. A thyroglossal duct cyst originates from the normal descent of the thyroid gland and occurs anywhere along the tract from the base of the tongue down the midline of the neck to just above the thyroid cartilage. Surgery to remove thyroglossal duct cyst includes options like the sistrunk procedure, sutureguided transhyoid pharyngotomy, en bloc central neck dissection, or koempels suprahyoid procedure. The cyst forms in tissue that is sometimes left over from the development of the thyroid gland. The initial symptoms of thyroglossal duct cyst carcinoma are indistinguishable from a benign thyroglossal duct cyst. Cystic lesions involving the tongue base are rare, generally presenting in pediatric patients, and they may encompass different pathologies such as ranula, lingual ectopic thyroid, thyroglossal duct cyst tdc, dysontogenetic cysts, benign, and malignant tumors. Thyroglossal cysts usually present as fluctuant swellings in the midline of the neck along the line of thyroid descent. Thyroglossal duct an overview sciencedirect topics. The thyroglossal cyst may occur anywhere from under the tongue, to the lower half of the neck. The lesions are usually painless and move with swallowing. All patients had surgery to remove the thyroglossal duct cyst and most of them had a followup surgery to remove their thyroid gland and lymph nodes 83%. Thyroglossal duct cysts often occur in children, but they may present at any age.
Most commonly, they present in the first decade of life. Removal of a thyroglossal duct cyst or sinus tract, also known as the sistrunk procedure after dr. Jul 05, 2019 the rupture of the thyroglossal cyst, or the incomplete removal of the thyroglossal cyst during the time of the surgery, results in the formation of a fistula. Sistrunk, involves a neck incision with dissection up to a small. Pdf the evolving concepts in treating thyroglossal duct cyst. The primary treatment for the infected thyroglossal duct cyst is the surgery of the cyst. Recurrences are attributed to variable histopathology and inadequate excision of the duct and its branching ductules. This can increase the risk of getting the lung infection called pneumonia after surgery.
Noscar transoral thyroglossal duct cyst tgdc excision is a newly developed treatment for tgdc, but limited information is available regarding the clinical outcomes in children. Thyroglossal duct cyst carcinoma should be suspected when the lesion is hard, fixed, and irregular. Thyroglossal duct cyst radiology reference article. In removing this cyst, cystectomy is considered inadequate. Operative techniques in otolaryngology head and neck surgery volume 20, issue 4, pages 256259, december 2009. Pdf the standard treatment for thyroglossal duct cyst tgdc is sistrunk operation, which consists of cystectomy, central hyoid bone segment. Pediatric thyroglossal duct cyst conditions and treatments. A thyroglossal duct cyst arises as a cystic expansion of a remnant of the tgd anywhere between the foramen of cecum and the isthmus of the thyroid. Thyroglossal duct cyst excisionthe sistrunk procedure. Thyroglossal duct cyst pictures, symptoms, treatment and. The technique for cyst removal shown in this video is the sistrunk procedure, which is the most commonly preformed procedure for thyroglossal cyst excision. The thyroglossal duct and cyst removal procedure involves the thyroglossal cyst, leftover pieces of the thyroglossal duct, and hyoid bone. Previous reports have suggested that thyroglossal duct cysts tdcs appear on sonograms as welldefined cystic masses with thin walls and posterior enhancement.
Neoplastic degeneration of a thyroglossal duct cyst. The thyroglossal cyst is the most common nonodontogenic cyst in the neck. Complications of a thyroglossal duct cyst may include. Pdf download postoperative instructions for a thyroglossal duct cyst removal. Thyroglossal duct cysts tgdcs are the most common congenital neck cyst and typically present in childhood or adolescence, although a subset remains asymptomatic until adulthood. In this paper, we report another case of thyroglossal papillary duct. Invasive thyroglossal duct cyst papillary carcinoma. Thyroglossal duct cyst to left of midline overlying lamina of thyroid cartilage figure 6 illustrates the distribution of thyroglossal duct cysts. The surgeons main concern is whether to perform thyroidectomy or not.
Jun 28, 2018 the initial symptoms of thyroglossal duct cyst carcinoma are indistinguishable from a benign thyroglossal duct cyst. Preoperative sonography in presumed thyroglossal duct cysts. The recommended surgery for thyroglossal duct cysts is the sistrunk procedure in which the central portion of the hyoid bone is removed, as well as the cyst. Dec 03, 2011 the thyroglossal duct attached to the cyst is dissected upwards. They are cysts of epithelial remnants of the thyroglossal tract and present characteristically as a midline neck mass at the level of the thyrohyoid membrane, closely associated with the hyoid bone. To help prevent this, your nurses will ask you to start walking as soon after your surgery as it is safe. Recovery from anesthesia usually occurs over several hours. Radiologic examinations revealed a bulky cystic lesion at the base of tongue with displacement of extrinsic lingual muscles. Thyroglossal cysts can be defined as an irregular neck mass or a lump which develops from cells and tissues left over after the formation of the thyroid gland during developmental stages. This paper describes the case of a 19yearold girl with phonation impairment and mild dysphagia due to limited tongue. The aim of this study was to evaluate the safety, efficacy, and effects of transoral tgdc excision in children. Apr 24, 2019 the thyroglossal duct and cyst removal procedure involves the thyroglossal cyst, leftover pieces of the thyroglossal duct, and hyoid bone. They may be found in as many as 7% of the population.
Many cystic remnants of the thyroglossal tracts are never detected clinically. Dang on alternative treatments for thyroglossal duct cyst. Papillary carcinoma arising in thyroglossal duct cyst in the lateral neck. Before 1893, the removal of a thyroglossal cyst in cluded simple incision and drainage. Thyroglossal duct cyst what is a thyroglossal duct cyst. The surgical management of thyroglossal duct remnants. Sistrunks 1920 description of thyroglossal cyst excision. Thyroglossal duct cyst tgdc disease, one of the most common developmental neck lesion in the pediatric population, often presents as infected neck mass. A radiologist or obgyn could use ultrasound to pass a needle through your abdominal wall to attempt to drain it.