OVERVIEW

What is a thyroglossal duct cyst?

During embryonic development, if the thyroglossal duct fails to regress or does not fully regress, it remains in the neck, forming a congenital cyst known as a thyroglossal duct cyst^[1]. Its location may be ventral or dorsal to the hyoid bone, embedded within the hyoid bone, or even within the thyroid gland^[2].

Is thyroglossal duct cyst common?

This condition is the most common cystic lesion in the neck^[3].

How many types of thyroglossal duct cysts are there?

They are classified into three types based on anatomical location.

Type I: The fistula (referring to a pathological drainage tract connecting the body surface to a hollow organ or between two hollow organs due to abscess formation) is not tightly connected to the hyoid bone, passing anterior or posterior to it without significant attachment.
Type II: The fistula is connected to the surface of the hyoid bone.
Type III: The fistula traverses through the hyoid bone^[4].

SYMPTOMS

What are the common manifestations of thyroglossal duct cysts?

The manifestations vary depending on the size of the cyst.

• When the cyst is small, it is usually asymptomatic, presenting only as a soft, painless, and non-tender mass in the midline or slightly off-center of the anterior neck.
• When the cyst is large, it may compress surrounding tissues, causing a sensation of tightness or fullness in the tongue or neck, leading to symptoms such as difficulty swallowing or breathing.

CAUSES

What are the common causes of thyroglossal duct cysts?

The exact cause of thyroglossal duct cysts is unclear, but it may be related to embryonic developmental abnormalities, radiation damage, and infection factors.

Who is more likely to develop thyroglossal duct cysts?

1. Children and adolescents: Since this condition is mostly a congenital malformation, it commonly occurs in children and adolescents^[4].
2. People with chronic neck inflammation: Untreated chronic neck inflammation may develop into this condition.
3. People with a family history of the disease: Due to its genetic predisposition, those with affected family members have a higher risk of developing it.

What are the triggering factors for thyroglossal duct cysts?

Genetic factors: Some literature suggests familial clustering of the disease, indicating a genetic predisposition. An important triggering factor for thyroglossal duct cysts is genetic inheritance^[5].

Is thyroglossal duct cyst hereditary?

It has a certain genetic tendency^[5].

DIAGNOSIS

Under what circumstances should patients with thyroglossal duct cysts seek medical attention?

Patients should seek medical attention promptly if a cyst is discovered during a physical examination or if they notice a mass in the midline of the anterior neck region. If symptoms such as pain, difficulty swallowing, or breathing difficulties occur, immediate medical care is required.

What tests are needed if a thyroglossal duct cyst is suspected?

1. Physical examination: If the cyst is large, a mass may be visible or palpable on the front side of the neck.
2. Laryngoscopy: This allows direct observation of the throat. A round, smooth-surfaced, grayish-white mass may suggest a preliminary diagnosis of thyroglossal duct cyst.
3. Ultrasound: This can accurately assess the size, location, and shape of the cyst and is the preferred method for diagnosing thyroglossal duct cysts.
4. CT scan: Used to evaluate the volume, location, and morphology of the cyst.
5. MRI: Similar to a CT scan but provides clearer visualization of the cyst's relationship with surrounding tissues.
6. X-ray imaging: An X-ray with contrast (iodized oil) may reveal an air-fluid level (the horizontal boundary between gas and liquid, aiding in the diagnosis of certain conditions) in the soft tissues around the hyoid bone.

TREATMENT

What department should patients with thyroglossal duct cyst usually visit first in the hospital?

Otolaryngology (ENT).
If the patient experiences symptoms such as difficulty breathing or severe dizziness, it is recommended to seek emergency care.

Can thyroglossal duct cyst be cured?

Yes.
With proper and standardized surgical treatment, symptoms can be alleviated or cured.
If left untreated or treated improperly, serious consequences such as malignant transformation may occur.

How is thyroglossal duct cyst treated?

Surgical treatment is the only effective method.

• Sistrunk procedure: The most classic and widely used surgical method, which effectively reduces recurrence rates^[4].
• Low-temperature plasma cystectomy under laryngoscopy: This method has the advantages of minimal trauma and faster recovery, but the recurrence rate is higher compared to the Sistrunk procedure^[4].

Is surgery necessary for thyroglossal duct cyst?

Surgery is recommended. Without surgical intervention, the condition may progress and lead to serious complications such as secondary infection or malignant transformation.

Is follow-up required after curing thyroglossal duct cyst?

Yes.
Untreated patients should undergo at least annual check-ups to monitor the cyst.
Postoperative patients typically have their first follow-up 1–2 weeks after surgery, followed by check-ups every three months.
Since patients' conditions and recovery vary, specific follow-up schedules should follow the doctor's advice.

Can thyroglossal duct cyst recur after treatment?

Recurrence is possible.

DIET & LIFESTYLE

What should patients with thyroglossal duct cysts pay attention to in their diet?

Maintain a balanced diet and consume more fresh fruits, vegetables, and high-quality proteins such as fish and shrimp.
Avoid overly hot, hard, or high-fat foods.
Spicy and irritating foods like garlic, onions, and chili peppers should be avoided.

What should patients with thyroglossal duct cysts pay attention to in daily life?

Patients should ensure adequate rest, maintain a regular sleep schedule, and develop healthy lifestyle habits.
Choose suitable exercises based on physical condition, such as walking or tai chi.
Pay attention to weather changes and stay warm.
Quit smoking and alcohol, and avoid coffee and strong tea.

How to care for a family member with thyroglossal duct cyst?

In addition to monitoring the patient's diet and lifestyle, family members should also pay attention to the patient's emotional well-being and help build confidence in overcoming the disease.

PREVENTION

Can Thyroglossal Duct Cysts Be Prevented? How to Prevent Them?

Yes, they can be prevented.

• People with chronic inflammation in the head and neck should seek active treatment to avoid long-term inflammatory stimulation leading to cysts.
• Workers frequently exposed to radiation should take protective measures.
• Individuals with a family history of thyroglossal duct cysts should undergo regular check-ups for early detection and treatment.