Congenital Abscess (Thyroid) Flashcards
What is congenital absence of the thyroid gland called?
Cretinism.
What is a thyroglossal cyst?
A cyst caused by the failure of obliteration of the thyroglossal tract which extends from the foramen cecum of the tongue to the apex of the pyramidal lobe.
How does the thyroglossal duct descend?
It moves downward crossing in front around or within the hyoid bone.
Where can a thyroglossal cyst be located?
Anywhere along the thyroglossal tract including the base of the tongue floor of the mouth suprahyoid region infrahyoid region prelaryngeal region or at the level of the cricoid cartilage.
What are the complications of a thyroglossal cyst?
Infection leading to pericystitis and abscess formation or the formation of a thyroglossal fistula.
What is the clinical presentation of a thyroglossal cyst?
A painless midline neck swelling in a child or teenager that moves up and down with swallowing and tongue protrusion.
What are the differential diagnoses of a thyroglossal cyst?
Cervical dermoid cyst subhyoid bursal cyst solitary thyroid nodule from the isthmus of the thyroid gland enlarged prelaryngeal and pretracheal lymph nodes branchial cyst and cystic hygroma.
How do the differential diagnoses differ from a thyroglossal cyst?
They move up with swallowing but do not move up with tongue protrusion.
What is a thyroglossal fistula?
An acquired fistula due to spontaneous rupture or incomplete excision of a thyroglossal cyst.
What can cause a thyroglossal fistula?
Incomplete drainage of a thyroglossal abscess.
What is the clinical presentation of a thyroglossal fistula?
An opening in the midline of the neck with a crescentic skin fold that moves up and down with swallowing and tongue protrusion with scanty discharge.
What is the treatment for a thyroglossal cyst or fistula?
Sistrunk’s operation.
What are the steps of Sistrunk’s operation?
An elliptical skin incision is made over the cyst or fistulous opening followed by dissection of the cyst or fistula track up to the hyoid bone removal of the central part of the hyoid bone and tracing the track to the base of the tongue.
What is a branchial cyst?
A congenital cyst in the upper lateral side of the neck.
What causes a branchial cyst?
Failure of obliteration of the cervical sinus during fetal life.
What is the clinical presentation of a branchial cyst?
A young adult with a lateral neck swelling behind the anterior border of the upper third of the sternomastoid muscle.
What are the characteristics of a branchial cyst?
Ovoid fluctuating smooth painless variable in size and has an ill-defined edge.
What are the complications of a branchial cyst?
Infection abscess formation branchial fistula due to spontaneous rupture or incomplete removal and adenocarcinoma.
What are the differential diagnoses of a branchial cyst?
Chronic cervical lymphadenitis cold abscess cystic hygroma carotid body tumor and submandibular salivary gland swelling.
How is a branchial cyst treated?
Excision.
What is a branchial fistula?
An opening in the lateral side of the neck along the anterior border of the sternomastoid with little discharge.
What are the types of branchial fistula?
Congenital and acquired.
What causes a congenital branchial fistula?
Failure of fusion between the 2nd and 5th branchial arches.
Where does a congenital branchial fistula extend?
From the pharynx between the internal and external carotid arteries to the skin of the neck above the sternoclavicular joint.
Can a congenital branchial fistula be bilateral?
Yes.
What causes an acquired branchial fistula?
Spontaneous rupture or incomplete removal of a branchial cyst.
Where is an acquired branchial fistula located?
In the upper lateral side of the neck along the anterior border of the sternomastoid.
How is a branchial fistula treated?
Excision using a step-ladder approach with multiple skin incisions to trace the fistula track to its origin.
What is a cystic hygroma?
A congenital lymphatic cyst.
What causes a cystic hygroma?
Obliteration of subcutaneous lymphatic vessels leading to the formation of a large lymphatic sac.
What is the clinical presentation of a cystic hygroma?
A newborn with a huge neck swelling which may cause obstructed labor.
Where is a cystic hygroma usually located?
In the posterior triangle of the neck.
What is a distinguishing feature of a cystic hygroma?
The swelling is brilliantly translucent due to clear lymphatic fluid.
How is a cystic hygroma treated?
Excision.
What is a branchial cyst?
A congenital cyst in the upper lateral side of the neck.
What causes a branchial cyst?
Failure of obliteration of the cervical sinus during fetal life.
What is the clinical presentation of a branchial cyst?
A young adult with a lateral neck swelling behind the anterior border of the upper third of the sternomastoid muscle.
What are the characteristics of a branchial cyst?
Ovoid fluctuating smooth painless variable in size and has an ill-defined edge.
What are the complications of a branchial cyst?
Infection abscess formation branchial fistula due to spontaneous rupture or incomplete removal and adenocarcinoma.
What are the differential diagnoses of a branchial cyst?
Chronic cervical lymphadenitis cold abscess cystic hygroma carotid body tumor and submandibular salivary gland swelling.
How is a branchial cyst treated?
Excision.
What is a branchial fistula?
An opening in the lateral side of the neck along the anterior border of the sternomastoid with little discharge.
What are the types of branchial fistula?
Congenital and acquired.
What causes a congenital branchial fistula?
Failure of fusion between the 2nd and 5th branchial arches.
Where does a congenital branchial fistula extend?
From the pharynx between the internal and external carotid arteries to the skin of the neck above the sternoclavicular joint.
Can a congenital branchial fistula be bilateral?
Yes.
What causes an acquired branchial fistula?
Spontaneous rupture or incomplete removal of a branchial cyst.
Where is an acquired branchial fistula located?
In the upper lateral side of the neck along the anterior border of the sternomastoid.
How is a branchial fistula treated?
Excision using a step-ladder approach with multiple skin incisions to trace the fistula track to its origin.
What is a cystic hygroma?
A congenital lymphatic cyst.
What causes a cystic hygroma?
Obliteration of subcutaneous lymphatic vessels leading to the formation of a large lymphatic sac.
What is the clinical presentation of a cystic hygroma?
A newborn with a huge neck swelling which may cause obstructed labor.
Where is a cystic hygroma usually located?
In the posterior triangle of the neck.
