What is a Thyroglossal Cyst

Thyroglossal cyst is an abnormal fluid-filled sac in the front of the neck that is present at birth (congenital). It forms from tissue left over after the thyroid gland develops in the lower front part of the neck.

Thyroglossal cysts are common and they often become infected.

What are the causes?

A thyroglossal cyst develops when open space in the neck fills with fluid or a thick mucus-like substance. This often happens after an upper respiratory infection. The open space is from a tube in the neck (thyroglossal duct) that is supposed to close and disappear before birth. Sometimes, the thyroglossal duct does not close, and a thyroglossal cyst develops.

What are the signs or symptoms?

Symptoms of this condition may include:

• A round lump in the front of the neck. The lump may be soft or hard, and it may move up and down when you swallow or stick out your tongue.
• Pain, redness, or swelling around the lump. These may be signs of infection.
• Difficulty swallowing or breathing. This is often present with large cysts.

How is this diagnosed?

This condition is diagnosed with a physical exam. Your health care provider may feel your throat and ask you to swallow and stick out your tongue. You may have tests, including:

• Blood tests.
• CT scan.
• MRI.
• Ultrasound. This uses sound waves to make an image of the cyst and surrounding area.

How is this treated?

Treatment for this condition depends on the severity of your symptoms. Treatment may include:

• Antibiotic medicine to treat an infection or shrink the size of the cyst.
• Surgery to remove the cyst. This may be done if you have infections that come back often (recur), or if the cyst:
  • Becomes infected.
  • Is large.
  • Causes difficulty breathing or swallowing.
  • Causes constant pain.
  • Affects your appearance.

Follow these instructions at home:

• Pay attention to any new symptoms or changes in your condition.
• Check your cyst and the surrounding area every day for signs of infection. Check for:

• More redness, swelling, or pain.
  • Warmth.
  • Increased size.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, or e-cigarettes. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have more redness, swelling, or pain around your cyst.
• Your cyst feels warm to the touch.
• Your cyst gets bigger.
• You have difficulty swallowing.

Get help right away if:

• You have difficulty breathing.
• You cannot swallow.
• You have severe pain.

Thyroglossal Cyst Removal

Thyroglossal cyst removal, also known as the Sistrunk procedure, is surgery to remove a fluid-filled sac in the front of the neck. A thyroglossal cyst develops when open space in the neck fills with fluid or a thick mucus-like substance. This open space is from a tube in the neck (thyroglossal duct) that is supposed to close and disappear before birth.

This procedure may be done if you have infections that come back often (recur), or if your thyroglossal cyst:

• Becomes infected.
• Is large.
• Causes difficulty breathing or swallowing.
• Causes constant pain.
• Affects your appearance.

Tell a health care provider about:

• Any allergies you have.
• Any recent colds or infections you have had.
• Any current or past tobacco use.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines or iodine.
• Damage to other structures or organs, such as the nerves that affect the tongue or voice box. This is rare.
• Scarring on the neck.
• Recurrence of the cyst.

What happens before the procedure?

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may have a physical exam of your neck and throat.
• You may have tests, including:
  • Blood tests.
  • Ultrasound. This uses sound waves to make an image of the cyst and surrounding area.
  • Thyroid uptake scan. This uses radioactive iodine to show where thyroid tissue is located.
  • CT scan.
  • MRI.
• Ask your health care provider how your surgical site will be marked or identified.
• Follow instructions from your health care provider about eating or drinking restrictions.
• You may be given antibiotic medicine to help prevent infection.
• Plan to have someone take you home after the procedure.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given medicine to make you fall asleep (general anesthetic). You may also be given medicine to help you relax (sedative).
• An incision will be made in your neck, over your cyst.
• Your cyst will be removed.
• A section of the small bone (hyoid bone) attached to your tongue will be removed. This is done to prevent another cyst from developing.
• If any part of the thyroglossal duct remains, it will be removed.
• A tube (catheter) may be inserted into your incision to drain excess fluid.
• Your incision will be closed with stitches (sutures), skin glue, or adhesive strips.
• Your incision may be covered with bandages (dressings).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• Do not drive for 24 hours if you received a sedative.
• You may continue to receive fluids and medicine through an IV tube.
• You will have throat pain, especially when swallowing. Medicines will be available to help you.
• If a catheter was inserted during your procedure, it may temporarily remain in place after your procedure.

Thyroglossal Cyst Removal, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain, swelling, and soreness in your throat.
• Difficulty swallowing.
• A hoarse voice.
• Blood in your saliva for a few days.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Driving

• Do not drive for 24 hours if you received a sedative.
• Do not drive or operate heavy machinery while taking prescription pain medicine.

General instructions

• Do not use any tobacco products, such as cigarettes, chewing tobacco, or e-cigarettes. If you need help quitting, ask your health care provider.
• If you have a drain, follow instructions from your health care provider about cleaning and maintaining the drain.
• Follow instructions from your health care provider about eating or drinking restrictions.
  • You may be told to eat only liquids for the first day after surgery.
  • If swallowing is painful, try eating soft foods until you feel better.
• Do not take baths, swim, or use a hot tub until your health care provider approves.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have pain that gets worse or does not get better with medicine.
• You have more redness, swelling, or pain around your incision.
• You have fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have hoarseness that does not get better in 7­–10 days.
• You have difficulty swallowing, and this does not go away after 1 week.
• Your cyst grows back.
• You have numbness or tingling in your throat or mouth.
• You vomit or feel nauseous.

Get help right away if:

• You have difficulty breathing.
• You cannot swallow.
• You have severe pain.