Thyroglossal Duct Remnants

Thyroglossal duct cysts result from thyroid tissue which fails to completely migrate during embryologic descent of the thyroid from its original position at the foramen cecum / base of tongue. It usually presents in preschool aged children as an asymptomatic midline mass at or below the level of the hyoid bone. It is found to move when the tongue is protruded. Occasionally, symptomatic lesions may present as pain, or difficulty with swallowing.

Treatment of a thyroglossal duct cyst consists of the Sistrunk operation, which is removal of the cyst to include the central portion of the hyoid bone and the tract to the foramen cecum, where it is ligated. In the setting of infection, acute treatment should consist of adequate drainage and intravenous antibiotics. There is a risk of malignant degeneration of thyroid tissue contained within the cyst if the remnant is left until adulthood.

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