Thyroglossal cysts

Question 1

What are thyroglossal cysts?

Answer 1

Painless swelling usually in the midline of the neck

Question 2

What is the aetiology of thyroglossal cysts?

Answer 2

Failure of the thyroglossal duct to close and disintegrate in foetal development after it has helped the thyroid grow and move into its anatomical position. Parts of the duct can widen, causing cysts. These cysts can fill with mucus (duct is lined with lymphoid and epithelial cells)

Question 3

What are the symptoms of thyroglossal cysts?

Answer 3

Painless swelling anywhere along the tract of the thyroglossal duct. Usually midline or slightly off midline. Usually subhyoid or suprahyoid. Moves upward then tongue is protracted or patient swallows (thyroglossal duct attached to tongue)

Question 4

what patient demographic commonly presents with a thryoglossal cyst?

Answer 4

Males = females

Commoner in younger patients

Question 5

What investigations would you organise to help diagnose a thyroglossal cyst?

Answer 5

Full blood count, TFTs - both come back normal
Ultrasound neck - midline cystic mass anterior to thyroid
Could do CT but USS preferred

Question 6

What are the complications of leaving an untreated thyroglossal cyst?

Answer 6

Risk of infection, can grow larger, can rupture

1% risk of malignancy

Question 7

What is the management of thyroglossal cyst?

Answer 7

Surgical removal (sistrunks procedure)
removal of cyst, tract and mid section of hyoid