What is Surgery – Thyroglossal cyst
DEFINITION Remnants of the thyroglossal tract were discovered along the thyroid gland's course of descent. AETIOLOGY The thyroglossal duct is an embryonic mesoderm tube that originates between the first and second branchial pouches, and is represented by the tongue's foramen caecum. During development, it descends to a pre tracheal location to produce the thyroid gland. The duct usually disappears by the sixth week, but if some tissue remains along its path, it may grow into a cyst. lingual or ectopic thyroid tissue is seen in one to two percent of cases. EPIDEMIOLOGY It mostly affects children or adolescents, and the average age of onset is 5 years (but it can range from 4 months to 70 years). Branchial cysts are three times as prevalent than ovarian cysts. HISTORY In the midline of the anterior neck, a swelling or lump is seen, which is usually asymptomatic, but in 5% of instances, there may be discomfort or rapid expansion due to infection. EXAMINATION Smooth, spherical swelling in the midline (90 percent; 10% can be lateral, with 95 percent on the left side), usually between the thyroid notch and the hyoid bone, but also occasionally in the submental region. Moves upwards with tongue protrusion and swallowing, and is frequently transilluminated. Lymph node, epidermal inclusion (dermoid) cysts, salivary duct abnormalities, or ectopic thyroid tissue are all possible differential diagnoses. PATHOLOGY/PATHOGENESIS Thyroglossal cysts can appear anywhere along the thyroglossal duct route, with 75 percent occurring before the hyoid. Non-keratinising stratified squamous, columnar, or cuboidal epithelium lines the cyst, which is filled with mucoid debris. Ectopic thyroid tissue may be present. INVESTIGATIONS To distinguish cysts from other structures (cysts have a high signal on T2 weighting) considered Ultrasound or MRI scan. Thyroid function tests in the blood. Pre-operative fine-needle aspiration cytology (typically benign epithelia, respiratory or squamous). MANAGEMENT Antibiotics are used to treat any type of acute infection. Surgical: The Sistrunk procedure (removal of the cyst and any duct remnants, as well as the central section of the hyoid bone) is used for excision. The tract may occasionally extend to the mouth, necessitating the removal of a tiny part of the tongue. COMPLICATIONS The most prevalent consequence is infection. After infection and spontaneous rupture, attempted drainage, or incomplete excision, a thyroglossal sinus or fistula may occur. Carcinoma in the thyroglossal duct cyst is a rare occurrence. PROGNOSIS Good, however even with good technique, recurrence rates are 7–8%, with infection being the most prevalent cause.
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