- Thyroglossal Cyst
It is the most common (75%) among congenital neck masses.
- Embryology
In the 4-8 week old embryo, a thyroid diverticulum develops in the place that fits the foramencecum. As the diverticulum progresses inferiorly, the triglossal duct is formed. As the thyroid gland develops, the duct obliterates and atrophy. The thyroid gland settles into its normal position in the 7th week of embryonal life. The canal closes in the 10th week. A cyst or fistula develops from the unclosed canal residues.
50% of the diagnosis is made between the ages of 2-6. There is no gender difference. 80% of cases present with a painless, smooth-surfaced, asymptomatic mass in the midline. The cyst may become infected by secondary infection to Upper Respiratory Tract Infection.
Localization
70% may be on the hyoid bone, 20% submental, rarely suprasternal, lingual, lateral.
- Physical Examination
The triglossal duct cyst is flat and soft, not tender. The upward movement of the mass when the tongue is protruded is typical.
- Diagnosis in thyroglossal cyst
The cyst and its tract are removed up to the base of the tongue, including the middle body of the hyoid bone.
By not excising the hyoid bone, the chance of recurrence increases greatly.
- Complications
Infection may develop in cases where surgery is not performed. Malignant degeneration (papillary Adenocarcinoma 10%) is seen. The most important point is that if the hyoidcorpus is not removed, recurrence occurs at a rate of 5-18%.
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