During the fetal period, many different structures develop from which the body systems develop. "Remains" from this period of development are supposed to degenerate and disappear altogether, yet this does not always occur in full.
A thyroglossal cyst is one such remnant, which is located in the front of the neck. It is a remnant of the development of the thyroid gland in the fetus, located between the tongue (glossus) and the thyroid gland (thyroid) in the neck - hence its name. This cyst can cause pain or infection which requires its removal.
When should a thyroglossal cyst be removed?
Thyroglossal cyst usually attracts attention at a young age - ages 2-10. It can manifest as a painful lump which appears in the child's throat.
In other cases, the cyst may become infected and cause local pain and tenderness, and even difficulty swallowing. It is often best to remove the cyst in order to prevent infection. If this happens, it is often advisable to take antibiotics and wait until the infection has cleared before removing the cyst.
The course of the surgery
To remove the cyst, the area where it is located in the neck must be exposed, through a small opening through which the cyst is found in its entirety.
In addition to removing it, the central part of the tongue bone (the hyoid) must be removed in order to reduce the chances of the fluid sac (cyst) returning. Bone removal reduces the chances of recurrence 10-20 times compared to when removing just the cyst. Furthermore, bone removal does not usually affect the child's speech or swallowing.
The operation is performed under general anesthesia and lasts about an hour.
Preparation before surgery
The diagnosis of the thyroglossal cyst is made by an ENT doctor. Sometimes additional imaging, such as ultrasound, is needed to confirm the diagnosis, characterize the location of the cyst, and determine the course of surgery.
In addition, should the surgery be under general anesthesia, a preliminary evaluation by an anesthesiologist must be performed. It is mandatory to be on a full food fast according to staff guidelines.
Recovery after removal of a thyroglossal cyst
Usually, the child stays in facility under observation for one night to make sure that no bleeding or swelling develops around the surgical incision. The patient can then return home, where he/she can return to their daily routine and school after the pain has subsided - usually a few days to a week post-operative.
Prior to discharge, precise instructions from your doctor will be provided on returning to a normal diet, on continued follow-up and on the recovery period.
Possible complications
After removal of the cyst, there may be an accumulation of fluid in the neck area (serum), an accumulation of bleeding (hematoma) or the development of an infection.
The risk of recurrence of the cyst is higher if the cyst has suffered infection prior to surgery.
More rare complications include local nerve damage and fistula formation (tissue connection via perforation). The recurrence rate of the cyst is about 2.5-5% after removal.
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