Treatment
Treatment for a thyroglossal cyst is surgical resection, often requiring concomitant removal of the midsection of the hyoid bone (Sistrunk procedure), to prevent recurrence. Although generally benign the cyst will be removed if the patient exhibits difficulty in breathing or swallowing, or if the cyst is infected. Even if these symptoms are not present the cyst may be removed to eliminate the chance of infection or development of a carcinoma,[1] or for cosmetic reasons if there is unsightly protrusion from the neck.
The Sistrunk procedure involves excision not only of the cyst but also of the path’s tract and branches. A removal of the central portion of the hyoid bone is indicated to ensure complete removal of the tract. It is unlikely that there will be a recurrence after such an operation. The original Sistrunk paper is available on-line with a modern commentary.[2] At times antibiotics can be indicated if there is sign of infection.
Thyroid scans and thyroid function studies are ordered preoperatively; this is important to demonstrate that normally functioning thyroid tissue is in its usual location.
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