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What are the indications for thyroglossal duct cyst removal?


Thyroglossal duct cysts (and/or tracts) that do NOT contain thyroid gland tissue and are NOT infected when identified are candidates for excision. If the cyst is infected the infection is treated first, then surgery can by performed.


What are the treatment options for thyroglossal duct cysts that contain thyroid tissue?


Thyroglossal duct remnants that contain THYROID GLAND (ectopic) tissue can also be candidates for removal if a normal functioning thyroid gland is identified, so removal of the ectopic tissue will not cause the patient to become HYPOTHYROID (have too little thyroid hormone).

If the only thyroid tissue found in the patient is located in the thyroglossal duct cyst, the treatment options are more complicated:


What is involved with thyroglossal duct remnant removal?


Prior to a thyroglossal duct cyst removal, thyroid function tests (to measure thyroid hormone levels in the body), as well as an imaging study (such as ultrasound, CT scan, thyroid scan) may be acquired to check for a normal thyroid gland. Many times, a normal physical exam and an ultrasound showing a normal thyroid gland is all that is required before surgery. Any infection detected will be treated with antibiotics before removal.

The surgery is performed under general anesthesia. A skin incision is made in the center of the neck near the lump in a natural skin crease (to decrease the scar). The entire thyroglossal duct cyst, along with a small portion of the hyoid bone (a small bone in the neck) and the cyst tract is then removed. This operation results in a 10-fold decrease in recurrences of the cyst compared to other types of surgical techniques. The surgical site is then sutured with techniques to minimize any visible scarring.


What are the complications of this procedure?


Wound infections and bleeding are complications of any surgical procedure. These complications are minimized using antibiotics and surgical techniques to reduce bleeding. An additional complication of the surgery could be creating an opening into the throat. This would be repaired immediately if recognized. Complications are more likely with repeat or revision procedures. Recurrence of a thyroglossal duct remnant is also a risk. 

HYPOTHYROIDISM, is an expected concern in those patients with all the body's thyroid tissue located in the thyroglossal duct remnant. An endocrinologist (gland specialist) will be required with the follow up of these patients.

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