Pediatric Thyroglossal Duct Cysts
During fetal development, the thyroid gland forms at the base of the tongue and drops down into its normal position in the neck in front of the wind pipe. During this time of development, the thyroid is connected to the tongue by a small tube called the thyroglossal duct. The duct is supposed to go away completely before the baby is born.
A thyroglossal duct cyst usually presents as a smooth, soft mass in the middle of the neck. If part or all of this thyroglossal duct persists, it can form a cyst (sometimes filled with mucous or saliva because of the connection to the tongue) in the center of the neck near the “Adam’s apple.” Since the cyst remains connected to the oral cavity, it can become infected and should be removed, preferably before any infection occurs.
Thyroglossal duct cysts are benign but can develop cancer in 1% of patients.
The treatment for thyroglossal duct cysts is surgical with a “Sistrunk procedure.” This involves resection of the cyst as well as a small portion of a bone in the neck called the hyoid bone. This is necessary because the thyroglossal duct goes through the center of the hyoid bone and the cyst is more likely to recur if the duct is not removed.
Removal of the center of the hyoid bone does not cause any problems.