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Thyroglossal Cyst

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Thyroglossal Cyst

Thyroglossal Cyst

A thyroglossal cyst is a congenital neck swelling formed due to remnants of the thyroglossal duct. It is the most common congenital midline neck mass and often presents as a painless lump that moves with swallowing or tongue protrusion. Surgical removal (Sistrunk procedure) is the definitive treatment.

What is a Thyroglossal Cyst?

A thyroglossal cyst develops when a portion of the thyroglossal duct (a channel through which the thyroid gland descends during fetal development) fails to disappear. This leads to fluid-filled cyst formation anywhere along the duct’s path — commonly in the midline of the neck, often just below the hyoid bone.

Symptoms of Thyroglossal Cyst

  • Painless midline neck swelling
  • Swelling moves with swallowing or tongue protrusion
  • Occasional tenderness, especially if infected
  • Redness or discharge if cyst becomes infected
  • Difficulty swallowing or breathing (rare, large cysts)

Causes & Risk Factors

  • Congenital persistence of the thyroglossal duct
  • Infection of the cyst leading to swelling and tenderness
  • Rare risk of carcinoma within the cyst (less than 1%)

Diagnosis & Evaluation

Diagnosis is based on clinical examination, imaging, and sometimes cytology.

  • Neck ultrasound to confirm cystic nature and assess thyroid position
  • CT/MRI if cyst is large or atypical in location
  • FNAC (Fine Needle Aspiration Cytology) if infection or malignancy suspected

Treatment: Sistrunk Procedure

The gold-standard treatment for thyroglossal cyst is the Sistrunk procedure, which significantly reduces recurrence.

Steps of the Sistrunk Procedure:
  • Removal of the cyst along with the entire thyroglossal duct tract
  • Excision of the central portion of the hyoid bone
  • Careful dissection up to the base of the tongue if needed
  • Closure with minimal scarring and good cosmetic outcome

Antibiotics may be required before surgery if the cyst is infected. Incision and drainage are avoided unless absolutely necessary.

Risks & Complications

  • Recurrence of cyst (rare with proper Sistrunk procedure)
  • Infection or wound complications
  • Scarring, generally minimal and cosmetically acceptable

Recovery & Aftercare

  • Most patients resume normal activity within 1–2 weeks
  • Keep the incision area clean and dry
  • Follow wound care and follow-up instructions strictly
  • Regular review to monitor healing and rule out recurrence

Why Choose Dr. Shrekha Padmakshan?

Dr. Shrekha Padmakshan provides expert management of thyroglossal cysts with precise surgical technique and excellent cosmetic outcomes.

  • Skilled in performing the Sistrunk procedure with minimal recurrence
  • Cosmetically placed incisions for best aesthetic results
  • Comprehensive evaluation and long-term follow-up

If you notice a persistent midline neck swelling that moves with swallowing or tongue movement, schedule a consultation for evaluation and definitive treatment.

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