SURGERY
Thyroglossal cyst
(TUBULOEMBRYONIC DERMOID CYST)
Common sites
- Beneath foramen cecum
- in the floor of the mouth
- above the hoid bone
- beneath hyoid
- on the thyroid cartilage
- at the level of cricoid cartilage
Definition
it is cystic swelling arising from remnant of thyroglossal duct - other name being median thyroid diverticulum
Structures which move up with deglutition
- thyroid swelling - swallow only
- subhyoid bursitis
- pretracheal and prelaryngeal lymph nodes
- thyroglossal cyst - with protrusion and swalling
Clinical Features:
Though congenital thyroglossal cyst appears around 15 to 30 yrs. Painless, midline swelling, more common in female.
The cyst is soft, cystic, fluctuant and transillumination test is negative. Cyst contains mucoid material
Moves with deglutition and with protrusion of tongue.
Complications:
- Recurrent and infections
- Abscess and fistula formation
- Papillary carcinoma.Z
Treatment:
Sistrunk’s Operation: Excision-Fistula with entire thyroglossal tract is excised.
Incomplete removal results in recurrence. CYSTTRActGOT Middle part of hyoid bone is taken also, may cause recurrence + fistula
Clinical Medicine
Structures which move up with deglutition:
- Thyroid swellings
- Subhyoid bursitis.
- Pretracheal and prelaryngeal lymph nodes.
- Thyroglossal cyst.
ENT
Embryology Thyroglossal trunk develops from the foramen caecum of the tongue and descends into the neck _ gives thyroid isthmus and medial parts of thyroid lobes.
Etiology Unobliterated portion of thyroglossal duct
Site At any point of the course of thyroglossal tract, commonest site is subhyoid in the midline.
Symptom usually child 6-8 years with swelling in the front of the neck - Painless mass in the midline of the neck(painful if infected).
Sign Cystic mass (Paget’s test) in midline of the neck moves with deglutition - and protrusion of the tongue.
Complication Thyroglossal fistula(always acquired &never cong.).
Investigation U/S _ cyst. - Fistulogram if fistula coexists.
Treatment
Sistrunk operation (excision of cyst, track and central part of hyoid bone).
