ENT/Surg Flashcards
Summarise features of a thyroglossal cyst?
Moves vertically with swallowing – suggests thyroid lesion or thyroglossal cyst.
The history of recent infection suggests thyroglossal cyst.
The thyroglossal tract arises from the foramen caecum at the junction of the anterior two-thirds and posterior one-third of the tongue. Any part of the tract can persist causing a sinus, fistula or cyst. With a thyroglossal cyst, the mass on the neck moves during swallowing or on protrusion of the tongue because of its attachment to the tongue via the tract of thyroid descent.
The persistent duct or sinus can promote oral secretions, which may cause cysts to become infected. Up to half of thyroglossal cysts are not diagnosed until adult life. The tract can lie dormant for years or even decades until some kind of stimulus leads to cystic dilation. Infection can sometimes cause the transient appearance of a mass or enlargement of the cyst, at times with periodic recurrences. Spontaneous drainage may also occur.
Features of lymphatic malformation?
Lymphatic malformation (lymphangiomas and cystic hygromas) arise from the embryonic lymph sac and are the second most common benign vascular tumours in children. Half are located in the head and neck area. 50% are present at birth and most present by 2 yrs of age. There is no genetic predisposition. Present as soft, painless masses that transilluminate. Rapid enlargement can occur with infection or haemorrhage. Can be treated using sclerosing agents.
Features of branchial cyst?
Branchial cysts account for nearly 20% of paediatric neck masses. Usually sit anteriorly to sternocleidomastoid. Usually present when a cyst becomes infected. Unlikely given location of mass (although 1% pre-auricular).
