Sistrunk Procedure for Thyroglossal Cyst

Introduction:

The Sistrunk procedure is a surgical technique used to treat thyroglossal cysts, which are congenital cystic masses that form along the path of the thyroglossal duct. This procedure involves complete excision of the cyst along with a portion of the thyroglossal duct and the body of the hyoid bone to prevent recurrence.

Understanding Thyroglossal Cyst:

Thyroglossal cysts are developmental anomalies that arise from remnants of the thyroglossal duct, a structure that connects the thyroid gland to the base of the tongue during embryonic development. When the duct fails to involute completely, cysts or sinuses can form anywhere along its path, typically in the midline of the neck.

Characteristics of Thyroglossal Cyst:

• Location: Thyroglossal cysts typically present as midline neck masses, most commonly located just below the hyoid bone or at the level of the thyroid cartilage.
• Consistency: These cysts are often smooth, fluctuant masses that may enlarge with swallowing or protrusion of the tongue.
• Association with Sinuses: In addition to cystic masses, thyroglossal anomalies may also present as sinuses or fistulous tracts that communicate with the oral cavity or the base of the tongue.
• Potential for Infection: Thyroglossal cysts can become infected, leading to symptoms such as pain, redness, and swelling in the neck.

Causes and Risk Factors:

• Developmental Anomaly: Thyroglossal cysts arise from embryonic remnants of the thyroglossal duct, which normally involutes during fetal development but may persist in some individuals.
• Genetic Factors: While most thyroglossal cysts occur sporadically, there may be a genetic predisposition in some cases, particularly in families with a history of congenital neck anomalies.

Signs and Symptoms:

• Neck Mass: The most common presenting symptom of a thyroglossal cyst is the presence of a painless, palpable mass in the midline of the neck, typically below the level of the hyoid bone.
• Swelling with Swallowing: The cyst may enlarge with swallowing or protrusion of the tongue due to its close proximity to the swallowing muscles.
• Symptoms of Infection: In cases of infection, patients may experience pain, tenderness, redness, and warmth over the affected area, along with systemic symptoms such as fever and malaise.