Thyroglossal duct cyst/Fistula

Introduction: The thyroglossal duct cyst is the most common congenital neck mass.

Clinical Presentation:

1. Painless mid-line neck swelling
2. Discharging sinus.
3. Painful mass (in c/o infected thyroglossal cyst)

Clinical diagnosis: Mid-line neck swelling moves with swallowing & also moves with protrusion of tongue.

Investigations:
1. Thyroid hormone tests T3,T4,TSH
2. Ultrasonography
3. Thyroid scan to rule out ectopic thyroid tissue.
Beside these tests, other optional tests are
4. CT/MRI
5. Fine needle aspiration cytology
6. Fistulography

Management:

Sistrunk procedure: Principle- excision of cyst along with fistulous tract extending up to the foramen caecum with central portion of hyoid bone (through which the tract goes)

In case of infected thyroglossal cyst, the preoperative antibiotic course is given & then the procedure carried out once the infection settles down.