The cyst of the thyroglossal duct is formed from residual cells of the thyroid gland during its formation during embryonic development. More specifically, it is a mass that is formed by the combination of cells and tissues that have remained after the formation of the thyroid gland in fetal life, in the area of ​​the neck. It is congenital, meaning that it is present from the moment the infant is born. Thyroglossal duct cyst removal is indicated if the increase in the size of this particular mass causes obstruction of breathing and swallowing.

What is the thyroglossal duct cyst?

The thyroid follows a specific path to take its final position towards the cervix through a channel called the thyroglossal duct, which ceases to exist after birth. Along the way, cells may be left behind, which can cause cavities and cysts to form, which are filled with mucus. Thyroglossal duct cyst appears as a painless, elastic bulge with a round and smooth shape, located in the midline of the neck, measuring 1 to 3 cm in length. In the majority it appears above the “Adam’s apple”, but it can also form below it. Rarely, this cyst is noticed in other areas, such as inside the mouth, behind the tongue or on the sides of the throat. The appearance of this specific cyst is most often detected during childhood, however, its appearance is not excluded both in adolescence and in adulthood.

Thyroglossal duct cyst: Symptoms

In some cases, the small size of these cysts means that they do not cause any problems. However, after an infection in the upper respiratory system, it can be prevalent, as it enlarges and manifests painful symptoms. An increase in the size of this particular mass may cause obstruction of breathing and swallowing, making the thyroglossal duct cyst removal necessary.

Symptoms that indicate the presence of a thyroglossal duct cyst are the existence of a small-sized and round-shaped mass in the central area of ​​the front of the neck. If the cyst has become infected, then a significant amount of sensitivity and redness is manifested, with a simultaneous appearance of swelling. The patient has difficulty swallowing food and breathing.

Treatment options & indications for thyroglossal duct cyst removal

Treatment options for this specific condition initially include the administration of antibiotics, in case of inflammation. Then follows surgery with total removal of the cyst. Removal is considered imperative as the presence of thyroid gland cells in the cyst cavity poses a risk of malignancy. In some cases the development of an infection in the cyst before surgery causes difficulties in the removal process and increases the possibility of future recurrence.

Thyroglossal duct cyst removal: Surgical process

Thyroglossal duct cyst removal is performed under general anesthesia, and then a small incision is made in the area where the cyst is located. The majority of these cysts are located high in the neck area, so the incision is horizontal. Because the cyst may abut the bone above the Adam’s apple, also known as the hyoid bone, part of that bone may be removed along with the cyst. This is known as Sistrunk procedure. Sometimes, along with the cyst, a blind duct that accompanies it is removed, which has a direction either towards the tongue, i.e. upwards or downwards, towards the point where the thyroid gland is located. At the end of the surgery, the incision is sutured using special intradermal plastic sutures, to avoid the creation of any scar. ENT Surgeon in Athens Dr. Olga Papadopoulou performs the specific procedure in order to relieve the problematic symptoms that the increase in the thyroglossal duct cyst’s size causes.