Excision of Thyroglossal Duct Cyst

Purpose – A thyroglossal duct cyst is a benign collection of fluid or mucus that can form a swelling in the middle of the neck. This swelling (cyst) is caused by leftover tissue from when the thyroid gland descended into the neck during fetal development. Small remnants of the gland can remain and cause swelling in the middle of the neck during childhood or young adult life. Although these cysts are usually benign, they should be removed to avoid repeated infection and more difficulty in treating the cyst later. 

Procedure – The procedure to remove the cyst is performed in an operating room under general anesthesia. An incision is made in the neck to remove the cyst along with part of the hyoid bone. Although the hyoid bone attaches to the back of the tongue, there are no ill effects from removing a portion of the hyoid bone. A drain is usually put in place to prevent formation of a blood clot under the skin. Most patients are sent home the same day with the drain in place. It is usually painful to swallow after the surgery for a week or two but most patients are able to tolerate a normal diet right away. The drain will be removed at the first postop visit or prior to hospital discharge. 

Recovery – After discharge, patients should rest at home with their head elevated. This minimizes swelling, pain and bleeding. There will be some pain, but medications will be recommended or prescribed to minimize discomfort. Any stitches will be removed during your post-op visit one week after the surgery. By this time, most patients can also resume their normal activities. The surgical incision will be noticeable at first, but over time it should camouflage nicely with the natural creases of the neck.
Risks & Complications – Every effort is made to remove the cyst in its entirety, but there is risk of cyst recurrence. The majority of patients have their cyst successfully removed in one procedure and never have another problem. If the cyst does come back, it may require further surgery. The nerves that move the tongue and supply the voice box with sensation are close to the surgical area. Although injuries to these nerves are rare with this procedure, because of their location, injury to them is possible. The incision will be carefully planned and closed in such a way as to minimize scarring. Bleeding and infection are also uncommon but possible developments during the healing process.