Thyroglossal duct cysts are fluid-filled masses near the thyroid gland that are present at birth and usually discovered when infected. Treatment involves removing the cyst or monitoring its size with ultrasound or thyroid scans. The Sistrunk surgical procedure may be necessary for larger cysts.
A thyroglossal duct cyst is a fluid-filled mass found near the thyroid gland and present at birth in some babies. This type of cyst is typically discovered when an infection causes the cyst to grow larger. Infected cysts can make it difficult to swallow and can be painful. Ultrasound or thyroid scans are used to check for a thyroglossal duct cyst. Treatment consists of removing the cyst or monitoring the size of the cyst.
During pregnancy, the thyroid gland migrates down the neck through a channel called the thyroglossal duct. Following this migration, the duct is reabsorbed by the body. In some children, however, a portion of the thyroglossal duct is not completely resorbed and is left to form a thyroglossal duct cyst.
Although this type of cyst is present at birth, it usually isn’t discovered until an infection causes the thyroglossal duct cyst to swell. The swollen cyst can then be easily palpated by a pediatrician. Enlarged and infected thyroglossal duct cysts can also cause your child pain when swallowing, difficulty swallowing, and a sore throat. Occasionally, an infected cyst can be seen protruding from the neck. Most often, this type of cyst is discovered between the ages of two and ten.
Once a thyroglossal duct cyst has been palpated by a pediatrician or is suspected, several tests can be done to confirm the diagnosis. The first test that is typically done is a blood test to determine if the cyst is interfering with the function of the thyroid gland. An ultrasound, thyroid scan, or both may also be ordered to visually check the cyst and determine its size and the cyst’s relationship to the thyroid.
Treatment of a thyroglossal duct cyst depends on the health and age of the child. First, antibiotics will be prescribed to destroy the infection inside the cyst. After the infection has been brought under control or eliminated, the size of the cyst will be re-evaluated. If your child can handle surgery and the cyst is large enough to interfere with swallowing and is near the thyroid, a Sistrunk surgical procedure will be done. If the cyst is small enough and surgery isn’t recommended for your child, the cyst will be periodically re-examined using an ultrasound and thyroid function will be monitored with blood tests.
The Sistrunk procedure removes the cyst and tissue along and including the original thyroglossal duct. If some of the thyroglossal duct tissue is left behind, another cyst can form. Sometimes part of the hyoid bone, or the small U-shaped bone located just under the chin, is also removed to be absolutely sure that none of the tissue from the duct remains in the neck.
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