MODERN MANAGEMENT OF THYROGLOSSAL DUCT CYST

Abstract

Thyroglossal duct cysts (TGCs) represent the most common congenital anomaly of the neck (7% of the population). They account for 2-4 % of all neck masses, and 70% of congenital neck abnormalities. Over half of cases are present in the first decade of life but they may also be seen in adults. Pyramidal lobe of the thyroid is the most common remnant of the thyroglossal tract and if no other thyroid tissue is identified, patients require lifelong replacement therapy after removal. TGCs arise from a persistent epithelial tract formed with the descent of the thyroid from the foramen caecum to its final position in the front of the neck. This duct obliterates early in fetal life. The duct so formed can rise in sinuses, fistulae or cysts. Symptoms can arise from the swelling itself or from complications, the most significant of which is infection. Surgical treatment of choice for TGCs is Sistrunk operation which includes dissection of the hyoid bone to the base of the tongue. Cancer has been reported in a small number of patients in whom the cyst is not removed until adulthood. Further studies are required to promote and establish novel treatment techniques, especially for recurrent cases.