What is the most common congenital anomaly of the neck?
The most common congenital anomaly of the neck is a thyroglossal duct cyst. The thyroglossal tract arises from the foramen cecum at the junction of the anterior two thirds and posterior one third of the tongue and runs to the level of the thyroid gland, along the embryologic migratory path of the thyroid gland. Any part of the tract can persist, causing a sinus, fistula, or cyst. The most common location for a thyroglossal duct cyst is midline or slightly off midline, between the isthmus of the thyroid gland and the hyoid bone or just above the hyoid bone ( Figure 61-17 ). These are most commonly noted in children as a palpable lesion but can occur at any age and might not become evident until adult life. Mucinous clear secretions may collect within these cysts, causing them to appear as spherical masses or fusiform lesions, rarely larger than 2 to 3 cm in diameter. Superimposed infection may convert these lesions into abscess cavities, and rarely, a cancer may develop in the cyst.