THROAT - Thyroglissal cyst

What is a  Thyroglossal cyst?

It is regarded as tubulodermoid arising from the persistent patent portion of the thyroglossal duct. Commonest midline swelling of neck during childhood and adolescent.

What  is the pathology of  Thyroglossal cyst?

Lining of cyst wall : Columnar epithelium sometimes squamous or cuboidal epithelium.

 

Contents : Transparent jelly like material with cholesterol crystals.
It is connected to the foramen caecum by remains of thyroglossal duct.

 

Sites : Anywhere between base of tongue and thyroid isthmus.
a)       Subhyoid (most common)
b)      Suprahyoid
c)       Region of thyroid cartilage
d)      At level of cricoid cartilage
e)       Floor of mouth
f)       In substance of tongue

What are the clinical features of  thyroglossal cyst?

1)Age:
a) Majority between 15-30 years of age
b) Patient may present with a painless lump near the midline of neck

2) Inspection:
a)       A swelling at the lower border of hyoid in midline or usually a little to the
left
b)      Along long axis of neck
c)       Overlying skin is free and normal is colour

3)      Palpation
a)       Fluctuant
b)      Transillumination : Rarely positive
c)       Swelling moves with deglutition and protrusion of tongue

 

what are complications of  thyroglossal cyst?

l)       Recurrent infections when swelling increases in size and becomes   painful
2)      Fistula

What is the treatment of thyroglossal cyst?

Sistrunk’s operation : Total excision of cyst or fistula with removal of central portion of  the hyoid bone.




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