Lesions of the face and neck

Question 1

Thyroglossal cyst and fistula

Answer 1

Persistence of the thyroglossal duct to forma cyst in the tongue or anterior neck.

A fistula forms when the cyst is perforated. Opens into
- Median neck, anterior to laryngeal carilage

Question 2

Thyroglossal duct

Answer 2

A connection between the thyroid and tongue during development.

As the thyroid descends during development, it is attached to the tongue by the duct temporarily.

Question 3

Thyroglossal cyst treatment

Answer 3

Surgery

• Sistrunk operation
• Removal of the hyoid bone body.

Question 4

Branchial fistula

• Description
• Complication
• Treatment

Answer 4

Persistence of the second pharyngeal groove and pouch forms a opening from the neck into the tonsillar sinus.

Complications
- Recurrent infection (infection from tonsillar sinus descends into neck)

Treatment
- Complete excision of the tract

Question 5

Ranula

Answer 5

Cyst of the sublingual gland found in the floor of the mouth.

Question 6

External auricular dermoid

Answer 6

Cyst found anterior to auricle of external ear.

Remnant of first pharyngeal pouch

Question 7

Cystic hygroma

• Description
• Treatment

Answer 7

Lymphangioma

• Cysts formed in lymph vessels
• Often in occipital triangle of the neck

Treatment

• Injecting sclerosants
• Surgery

Question 8

Haemangioma

• Description
• Management

Answer 8

Benign vascular tumour

Typically left alone
- May resolve with time

May need surgery if affecting peri-oribal area (vision problems complication)