Thyro glossal duct cysts

Thyroglossal cysts

These are quite common lumps in the front of the neck.  They are usually just to the left of the midline or in the midline and vary in size from a pea to a tangerine.

These usually originate along the embryonic route of the thyroid as it makes its way from the back of the tongue to lie in the bottom of the front of the neck.. The cyst often has some of the duct (tube) attached and this is important as unless this duct is removed as well as the cyst, the lump will come back.

The correct operation is named a Sistrunk's operation and aims to remove the cyst and any of the duct in one block. One key step is to remove the central part of the hyoid bone as the duct can lie behind it. The block is then extended up into the base of the tongue.

Recurrent thyro-glossal cysts require a further block excision of the lump surrounded by a cuff of normal tissue.

Larger cysts require a wider excision from the outset