Treatments for Thyroglossal Duct Cyst in Children

How is a thyroglossal cyst treated?

Unless your child's cyst is infected, your doctor will recommend surgical removal. If it's infected, the infection must be controlled before surgery can be done.

The only appropriate treatment for a thyroglossal duct cyst is its surgical removal. There are no medicines or therapies which will produce its resolution. It has been well documented the removal of a thyroglossal duct cyst before it has become infected results in a better outcome and lower risk of recurrence than if the cyst is removed after previous infection.

In the surgical removal not only the cyst, but its connection up to the base of the throat must be removed to prevent recurrence. Studies have shown that there can be some branching of the tract as it comes down from the pharynx which can lead to failure to remove the entire tract and result in recurrence. To decrease the risk of recurrence, the central portion of the hyoid bone, which was mentioned previously, is removed. This is done because the tract can travel anterior or posterior to the bone or actually within it. The recurrence rate can be up to 50 percent if the bone is not removed. There is no functional loss from removal of this segment of bone and, in fact, it will often fuse back together following surgery. Complications of removal of the cyst can be either infection in the incision which is a particular risk if the cyst was infected at the time of its removal, and of recurrence of the cyst requiring a secondary resection. The scar is generally high up at the junction of the neck and the jaw so that it is not visible unless the neck is extended.

What happens on the day of surgery?

It's a fairly simple operation.

General anesthesia is used. You will meet with the anesthesiologist and the surgeon on the day of surgery. Most children go home the same day unless there are any breathing problems or a small drain is placed in the wound. In those cases, your child may need to stay overnight.

After surgery, your child will stay in the Day Surgery Unit until he or she is ready to go home. Parents are welcome to stay with their child during this time.

What happens after surgery?

  • You will be given a written instruction sheet before you go home telling you how to care for your child.
  • Your child will probably have some discomfort after the operation. The doctor may prescribe pain medicine. Give pain medicine as prescribed and instructed by your doctor and nurse.
  • It is usually not necessary to remove stitches. They are under the skin and dissolve on their own.
  • A clear waterproof dressing or bandage may be applied to the incision.
  • Your child may shower or have a sponge bath at home one to two days after surgery.
  • Your child's doctor will ask you to make a follow-up appointment about 2 weeks after the surgery to check how the area is healing.

My child's cyst seems infected. Should we postpone the surgery?

It depends. If the area near the cyst becomes red, tender, swollen, or drains, please call your surgeon.