A thyroglossal duct cyst (TGDC) is the most common congenital neck mass in children. It is a fluid filled mass located in the midline of the neck that is usually not found until age 2 but has been present from birth (congenital). A TGDC is formed of cystic tissue from a descending duct that forms the thyroid gland during embryonic development.
Signs and Symptoms of Thyroglossal Duct Cyst in Children
- A small, soft, round lump in the midline of the neck
- Tenderness, redness, and swelling of the lump (abscess), if infected or intermittently draining sinus
- Trouble swallowing or breathing
- Often are asymptomatic
- The cyst is formed from leftover tissue from the development of the thyroid gland when an embryo was forming
Diagnosis Thyroglossal Duct Cyst
Physical exam and ultrasound. The thyroglossal duct cyst lies in close proximity with the hyoid bone.
Surgery for a Thyroglossal Duct Cyst in Children
Treatment for thyroglossal duct cysts is surgical removal of the cyst, associated duct and a small portion of the hyoid bone to prevent recurrent infections. This procedure is called a Sistrunk procedure.
Postoperative and Rehabilitation Care
Following the surgical removal of a thyroglossal duct cyst, patients are instructed to avoid strenuous activities for 2 weeks. Depending on the size of the thyroglossal duct cyst, there may be a surgical drain or rubber band in place, which would be removed in 24 hours. Pain medication or antibiotics may be prescribed postoperatively. Children can usually return to or school 1 week after surgery. Most of the time this procedure is completed as an outpatient.
Neck Masses in Children – Differential Diagnosis
- The differential diagnosis of a midline neck mass includes:
- Thyroglossal duct cyst
- Dermoid cysts
- Lymph nodes
Thyroglossal duct cysts move up with swallowing and can be infected, while dermoid cysts do not do either.
Please call the Dr. Baktha if your child has any of the following symptoms:
- Fever (a temperature of 101.5 degrees or higher)
- Any signs of infection, including redness, swelling or pain
- Any drainage from the incision
- Any pain that is not controlled with the prescribed pain medicine
- A mass or lump in the center of the neck
- Any further questions or concerns