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Thyroglossal Duct Cysts: A Clinicosurgical Experience
Suhail Amin Patigaroo1, Nisar Hussain Dar1, Aleena Shafi Jallu1
1Postgraduate Department of ENT, HNS, Government Medical College, Srinagar, Jammu and Kashmir India.
Insights
Thyroglossal duct cysts are common congenital neck masses in children, often presenting as midline neck swellings. This study highlights their typical subhyoid location and varying thyroglossal duct lengths observed during surgery.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Congenital Abnormalities
Background:
- Thyroglossal duct cysts are the most frequent congenital neck mass, affecting approximately 7% of the population.
- These cysts arise from the incomplete involution of the thyroglossal duct and are commonly diagnosed in pediatric patients.
- The majority of thyroglossal duct cysts are located in the infrahyoid region of the neck.
Purpose of the Study:
- To present a 5-year clinical experience with thyroglossal duct cysts.
- To analyze clinical features and surgical findings, focusing on the visible extent of patent thyroglossal ducts.
- To document the naked-eye observation of thyroglossal duct patency, a novel aspect in clinical studies.
Main Methods:
- A prospective observational study conducted over five years (January 2011 to January 2016).
- Inclusion of thirty patients with histopathologically confirmed thyroglossal cysts.
- Diagnosis based on clinical history, physical examination, and ultrasound (USG) findings; data analysis included cyst size, location, and thyroglossal duct characteristics.
Main Results:
- The study included 30 patients, with a mean age of 10 years; 73.3% were under 15 years old, and 73.3% were male.
- Neck swelling was the primary presentation in 90% of patients, with 83.3% of cysts located in the subhyoid region.
- Thyroglossal ducts showed variable patency: 80% extended to the superior border of the hyoid bone, 10% to the vallecular mucosa, and 3.3% were completely patent to the base of the tongue. Absent tracts were noted in 6.7%.
Conclusions:
- Thyroglossal duct cysts predominantly affect pediatric males and typically present as midline neck swellings.
- Subhyoid location and sizes ranging from 1.5-3 cm are characteristic.
- While complete duct patency is rare, partial patency to the hyoid bone is common; no malignant features were observed.
Abstract:
Thyroglossal cyst is the most common congenital neck mass and occurs in 7% of the population. They occur due to failure of thyroglossal duct to involute and atrophy thyroglossal duct cysts often occur in pediatric patients. Majority of them are found infrahyoid region. The purpose of the present study is to report our 5 year clinical experience of thyroglossal cysts in terms of clinical features and surgical findings with special emphasis on naked eye extend of patent thyroglossal duct when present. To the best of our knowledge this is first clinical study which has reported the extend of thyroglossal duct on naked eye. This prospective observational study was done in the Postgraduate Department of ENT, Head and Neck surgery of Government medical college, Srinagar for a period of five years from January 2011 to January 2016. Thirty patients of histopathologically confirmed thyroglossal cysts were enrolled in the study. Patients were initially diagnosed on the basis of clinical history, examination and USG findings suggestive of cyst. Clinical data and surgical data in terms of size and location of cyst, presence or absence of thyroglossal duct etc. was analyzed and formulated in tables for patients who had histopathologically confirmed cyst. Mean age was 10 years. Majority (73.3%) were less than 15 years of age. Males were 22 in number (73.3%) while females compromised 26.7% of population. Ninety percent of patients presented with neck swelling. Erythema/redness over swelling was seen in 13.3% of patients. Majority (83.3%) of cysts were subhyoid in location. Thyroglossal ducts were seen to be patent for different lengths and areas. Majority of patients (80%) had tract arising from cyst and disappearing at superior border of hyoid body while three patients (10%) had patent thyroglossal duct from cyst to vallecular mucosa. A complete patent thyroglossal duct was seen in one patient (3.3%) from cyst to base of tongue. Complete Absent tract was seen in two patients (6.7%). Majority (70%) of cysts were having size between 1.6 and 3 cm. Intraoperative 10% of cyst got ruptured. Thyroglossal cysts are most commonly seen in pediatric males. Most of them present with visible midline neck swelling. In few cases cyst can rupture after repeated infections leading to sinus formation. Most of them are subhyoid in location. These cysts are usually of size 1.5-3 cm. Complete patent thyroglossal duct from cyst to tongue musculature is rarely seen while most of the times, a patent duct just disappears at the superior border of body of hyoid. None of our cysts had malignant features.
