Embryology
- The thyroglossal tract arises form foramen caecum
- Arises at junction of anterior 2/3 and posterior 1/3 of the tongue
- Any part of the tract can persist causing a sinus, fistulae or cyst
- Most fistulae are acquired following rupture or incision of infected thyroglossal cyst
Clinical features
- Thyroglossal cysts are usually found in subhyoid portion of tract
- 75% present as midline swellings
- Remainder can be found as far lateral as lateral tip of hyoid bone
- The cyst elevates on protrusion of the tongue
- Male : female ratio is approximately equal
- 40% present < 10 years of age
- 65% present < 35 years of age
- Often present as an infected cyst due lymphoid tissue in the cyst wall
- If infected aspirate cyst rather than incise
- Prevents formation of thyroglossal fistula
Treatment
- Sistrunk Operation
- Transverse skin crease incision
- Platysma flaps raised. Cyst dissected
- Middle 1/3 of hyoid and any suprahyoid tract extending into the tongue dissected
Bibliography
Brewis C, Mahadevan M, Bailey C M, Drake D P. Investigation and treatment of thyroglossal cysts. J
R Soc Med 2000; 93: 18-21.
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