Thyroglossal Duct Cyst

Excerpt

Thyroglossal duct cysts are the most common congenital cervical anomalies, with a prevalence of 7% in the population. These cysts arise from the incomplete closure of the thyroglossal duct, an embryological structure formed during the thyroid gland’s descent from the base of the tongue to the lower neck. Thyroglossal duct cysts typically present as midline neck masses near the hyoid bone and can occur anywhere along the thyroid’s developmental path. While thyroglossal duct cysts are most commonly found in childhood, usually before age 10, they can also appear later in young adults as painless, mobile masses. Moreover, these cysts may develop into sinuses and fistulas or become infected.

Diagnosis relies primarily on ultrasound, which is noninvasive and well-suited for pediatric evaluation. Surgical removal is the standard treatment to prevent infection and reduce recurrence risk, with the Sistrunk procedure being the preferred method due to its lower recurrence rates. Infected cysts should be treated with antibiotics prior to surgery. In rare cases where no normal thyroid tissue is present, hormone replacement therapy may be required after excision. Emerging alternatives like ultrasound-guided ethanol ablation are also being explored as potential treatment options.