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Thyroglossal Duct Cyst (Fluid-filled midline structure caused by an
abnormality on the migration of the thyroid gland)
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In the fetus
the thyroid gland originally forms at the base of the tongue. Early in
fetal life it then "migrates" or moves from the base of the tongue
inferiorly to end up at the base of the neck overlying the airway
(trachea). Sometimes when the thyroid migrates it drags with it some of
the lining of the pharynx which can persist as a tract with a cyst at
its base along the route of migration of the thyroid gland (see the
figure). This then produces a thyroglossal duct cyst which is the result
of accumulation of a gelatin-like material secreted by the lining of the
cyst or tract. The tract from the base of the tongue can travel through,
or immediately in front of, or behind the hyoid bone. The main risk of a
thyroglossal duct cyst is that it can become infected by bacteria from
the mouth traveling through the tract to the cyst.
- A thyroglossal cyst usually appears between the second to 10th
year of life.
- It is found equally in both sexes.
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Common Signs and Symptoms:
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- The cyst is seen as an asymptomatic midline neck mass often around
the hyoid bone
- The cyst is round and firm with no external opening
- It moves up when the tongue is stuck out of the mouth or with
swallowing
- Occasionally it can be seen to one side or other of the breathing
tube
- Bacteria from the mouth may infect the thyroglossal duct cyst
through the thyroglossal duct tract causing sudden swelling of the
cyst and redness or tenderness in the area of the cyst.
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- Surgical excision is recommended unless infection is present.
- Uncomplicated excisions and postoperative course permit discharge
from the hospital several hours after the procedure. Overnight stay
may be indicated if there is any hint of airway problems suspected or
a drain is placed during the procedure.
Information provided from Child Health A to Z, Children's Hospital
Boston web site
www.childrenshospital.org
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