What is a thyroglossal duct cyst?
A thyroglossal duct cyst is a fluid-filled lump that develops in the midline of the neck, often just below the chin. It forms due to remnants of the thyroglossal duct, a structure present during early fetal development that usually disappears before birth. If this duct does not fully close, a cyst can develop.
Thyroglossal duct cysts are usually benign but can become infected, causing pain, swelling, and discomfort. In rare cases, they may contain thyroid tissue, which can lead to further complications.
What causes a thyroglossal duct cyst?
A thyroglossal duct cyst is a congenital condition, meaning it develops before birth. It occurs when the thyroglossal duct fails to close completely, leaving a small pocket that can fill with fluid and form a cyst.
Although the cyst may be present from birth, it often goes unnoticed until later in childhood or adulthood, especially if it becomes infected or enlarges.
What are the symptoms of a thyroglossal duct cyst?
Many people with a thyroglossal duct cyst do not experience symptoms until the cyst becomes enlarged or infected. Symptoms may include:
- A painless lump in the middle of the neck, which may move when swallowing or sticking out the tongue
- Swelling and tenderness, especially if the cyst becomes infected
- Redness and warmth over the cyst due to infection
- Difficulty swallowing or breathing if the cyst grows large enough to press on nearby structures
- Recurring infections in the cyst, leading to abscess formation
If a thyroglossal duct cyst becomes repeatedly infected or causes discomfort, surgical removal is usually recommended.
How is a thyroglossal duct cyst diagnosed?
To confirm the presence of a thyroglossal duct cyst, your doctor may recommend:
- Physical examination – checking for a lump that moves when swallowing or sticking out the tongue
- Ultrasound scan – to assess the cyst’s size and structure
- CT or MRI scan – sometimes used to evaluate deeper cysts or rule out other neck masses
- Fine needle aspiration biopsy (FNA) – in rare cases, a sample may be taken to rule out other conditions
It is important to ensure the thyroid gland is functioning normally before treatment, as some thyroid tissue may be located within the cyst.
How is a thyroglossal duct cyst treated?
The most effective treatment for a thyroglossal duct cyst is surgical removal, as cysts can recur or become infected if left untreated.
Surgery (Sistrunk procedure)
The Sistrunk procedure is the standard surgical treatment for a thyroglossal duct cyst. It involves:
- Removing the cyst and part of the thyroglossal duct to prevent recurrence
- Excising part of the hyoid bone, as remnants of the duct can be embedded in this bone
- Closing the incision with dissolvable stitches, usually leaving a minimal scar
This procedure significantly reduces the risk of recurrence, as simply draining the cyst is not effective in the long term.
What are the risks of surgery?
Thyroglossal duct cyst surgery is safe and well-tolerated, but like any procedure, it carries some risks, including:
- Bleeding or infection – rare but possible complications
- Scar formation – usually minimal, but some people may develop a more noticeable scar
- Recurrence – if part of the thyroglossal duct is not completely removed, the cyst may return
- Temporary difficulty swallowing or mild voice changes – uncommon but possible if swelling affects nearby structures
What happens after surgery?
Most patients recover quickly and are discharged on the same day or the following day.
Post-surgery care:
- Mild discomfort can be managed with pain relief such as paracetamol or ibuprofen
- Swelling and bruising gradually subside within a few weeks
- You can resume normal activities within a few days, but should avoid strenuous activity for 1–2 weeks
- Follow-up appointments ensure the wound is healing properly and that no recurrence occurs
Why choose Birmingham Head and Neck Clinic?
At Birmingham Head and Neck Clinic, we offer expert diagnosis and treatment for thyroglossal duct cysts. Our experienced surgeons provide:
- Accurate diagnosis using advanced imaging techniques
- Minimally invasive surgical options for fast recovery and minimal scarring
- Comprehensive aftercare and follow-up support to ensure the best outcomes
Contact us
If you have noticed a lump in your neck or have concerns about a thyroglossal duct cyst, we are here to help.
