Thyrohyoid cyst, introduction to thyroglossoid duct cyst

What is a thyrohyoid cyst?

Thyroid hyoid cyst is a congenital cyst formed on the midline of the anterior cervical region due to incomplete degeneration of the thyrohyoid bone during fetal development, which is more common in adolescents and can occur in both men and women. The thyrohyoid cyst is located between the hyoid bone and the thyroid cartilage on the anterior midline of the neck, and a mass appears during the development stage, and there are generally no obvious symptoms. If infection occurs, there will be redness, swelling, pain and heat, and after the ulceration, it is easy to form a fistula that does not heal for a long time, and secretes a white mucus-like substance.

Thyroid hyoid cyst (fistula): caused by incomplete degeneration of the thyroid tongue duct or epithelium. The thyroid tongue duct appears in the third week of fetal development, with its upper end at the floor of the original oral cavity and its lower end at the thyroid gland degenerating by the fifth week of fetal development.

The upper end segment is left as a blind hole at the base of the tongue.

Thyroid hyoid cysts are usually located in the midline of the neck, under the hyoid bone, in a garden-shaped shape, about 2 3 cm in diameter, and have a smooth surface without tenderness. On examination, the cyst is fixed and cannot be moved upwards or sideways, but is characterized by upward movement of the mass when swallowing or protruding the tongue. Large, superficial cysts have a positive light transmission test, and smaller cysts may be palpable with a cord connecting to the hyoid bone.

In adolescence, due to cystic secretion retention or complicated infection, the cyst can burst to form a fistula, the fistula can extend upward, close to the front and back of the hyoid bone or through the hyoid bone to the blind hole, the fistula often discharges translucent mucus, after a period of time, the fistula can temporarily heal and scab over, and soon break due to secretion retention, so that the fistula can heal from time to time, and a cord tissue sneaking in the direction of the hyoid bone can be palpated on the fistula.

**The method is to remove the cyst or fistula completely, and the cyst or fistula must be completely removed together with the middle part of the hyoid bone, and the muscles adjacent to it above the hyoid bone must be removed, directly to the blind hole at the base of the tongue, so as to ensure that it is no more**.

Thyroid hyoid cysts cannot be treated with drugs** and can only be surgically applied**.

Whether it is a submandibular or submental region, as it is necessary to determine whether it is a thyrohyoid cyst or a submandibular gland cyst.

Yantai Yuhuangding Hospital - Department of Otolaryngology - Chief Physician Zhang Qingquan.

Hyoid cysts are caused by congenital developmental anomalies.

Surgery required**.

You can usually be discharged from the hospital within 7 days after surgery.

If it is a complete excision.

No**. If the excision is not thorough enough.

Yes, it will**.

Congenital disorders.

Caused by patent thyroglossal duct after birth.

Early surgery is recommended.

Malignant transformation is rare.

This is an open classification of thyroglossal duct cysts, with a total of 1 entries (including subclasses).

Thyroglossal cyst refers to a congenital cyst left in the neck during the early embryonic thyroid gland development, when the thyroglossal duct does not degenerate and does not disappear. Epithelial secretions often accumulate in the cyst, and the cyst can communicate with the oral cavity through the blind foramen of the tongue, and secondary infection can cause the cyst to break down and form a thyroglossal fistula.

At the fourth week of embryonic development, the endoderm between the first pair of pharyngeal sacs and the ventral side of the pharyngeal cavity sinks downwards to form a diverticulum-like structure, that is, the thyroid primordial base, which then extends into the interstitium below to form a normal thyroid gland in front of the mid-cervical trachea. At week 6, the thyrohyoid canal degenerates on its own, leaving only a shallow concave at its origin, known as the blind foramen of the tongue. If the thyroglossal duct does not degenerate completely during this process, the remaining epithelium can form a thyroglossal tract cyst during the course from the anterior median base of the neck to the thyroid gland; The cyst can communicate with the blind foramen of the tongue through the undegenerated thyroglossal canal. If the cyst becomes secondary to infection, forms an abscess and punctures itself**, or an incision and drainage is performed to form a fistula that does not heal for a long time, it is a thyroglossal tract sinus.

While the thyrohyoid canal descends, the second pair of branchial arches fuses anteriorly to form the hyoid body, so that the thyrohyoid duct cyst can adhere to or behind the hyoid body, or pass through the hyoid body.

The occurrence of thyroglossal duct cysts is not significantly related to gender, and can occur in both men and women; It can occur at any age, but is more common in adolescents under 30 years of age. Cysts can occur anywhere between the anterior median lure and the sternal notch, most commonly up and down the body of the hyoid bone, and sometimes to one side. The cyst is mostly round, slow-growing, no conscious symptoms, soft, clear perimeter, no adhesion with the surface ** and surrounding tissues, the cyst located below the hyoid bone, between the cyst and the hyoid bone body, sometimes a tough cord-like object can be palpated, and the cyst can move up and down with swallowing and tongue protrusion; If the cyst is located near the blind foramen of the tongue, when it grows to a certain extent, the base of the tongue can be elevated, and swallowing and language dysfunction may occur; When the cyst is secondary to infection, it can be painful to take out the object, especially when swallowing, the surface is red, adhesion, the boundary is not clear, the cyst is punctured ** or the nail tongue fistula is formed by incision and drainage, and the cyst can disappear at this time.

Atrohylossal fistula is a small fistula with yellowish or purulent mucus for a long time, and can flare up acutely when the fistula is blocked.

Thyroglossal duct cysts should be distinguished from dermoid cysts, sublingual gland cysts, submental wide lymphadenitis, thyroid nodules or ectopic thyroids, hemangiomas, lipomas, etc.

Surgical complete excision of cyst or fistula is the main method of thyroglossal cyst or fistula, due to the relationship between the fistula and the hyoid body, the middle part of the hyoid bone connected to it and the soft tissue between the blind foramen of the tongue should be removed during surgery for columnar excision to prevent **.

Thyroid cyst is a common disease, which refers to the discovery of a cyst containing fluid in the thyroid gland, and the thyroid cyst has no obvious symptoms at the beginning, unless the cyst is large or there is bleeding in the cyst, which may cause some symptoms of compression. Although the initial symptoms of thyroid cyst are not obvious, the harm cannot be ignored, and in severe cases, it endangers the patient's life, what is the cause of thyroid cyst?

Causes of thyroid cysts:

1) Iodine deficiency or excess in soil and water in endemic areas.

2) Increased iodine requirements (growth and development, breastfeeding, cold, infection, poisoning, mood, etc.).

3) Goiter (cassava, radish, cabbage, thiouracil, thiocyanate, sodium p-aminosalicylate, Baotai containing this pine, potassium perchlorate, cobalt, lithium salt).

4) Drinking deep well water (too much sulfur hydrocarbons, calcium, fluorine), the water source is contaminated by bacteria.

5) Familial congenital thyroid hormone synthetase deficiency. Thyroid tissue has a strong ability to concentrate iodine, and the human thyroid gland needs 60-80ug of iodine per day to produce physiologically active thyroid hormones. In the case of iodine deficiency, thyroid cells cannot synthesize enough thyroid hormones, the concentration of thyroid hormone in the blood decreases, the inhibitory effect of thyroid hormone on pituitary secretion (TSH is weakened), and the secretion of TSH increases and the level of TSH in the blood increases, causing thyroid hyperplasia.

Drinking Chinese medicine for half a year has no effect.

I would like to ask if I need to do another test to confirm the condition? (Puncture and ultrasound were done).

Song Fengzhu, Department of Otolaryngology, Department of Head and Neck Surgery, First People's Hospital of Jining City.

Home improvement tongue cyst is a congenital cyst, originating from the remnants of the thyroid tongue duct in the embryonic stage, the asymptomatic cyst enlarges at the beginning before feeling the swelling in the tongue, and the pharynx has a feeling of foreign body blockage, which affects speech and affects swallowing and pronunciation. Examination reveals a round bulge at the base of the tongue.

The puncture can aspirate a cool or cloudy liquid, which is light yellow in color, thick and not necessarily liquid. If the infected cyst becomes more painful, it may break the hole and discharge pus, forming purulent sinus tracts. You've done a puncture and ultrasound.

Diagnosis can be confirmed, only surgery**. It's a minor surgery.

Song Fengzhu, Department of Otolaryngology, Department of Head and Neck Surgery, First People's Hospital of Jining City.

Corrected: Pretending to be a nail form, writing error, sorry! The correct one is a cyst at the base of the tongue.

Song Fengzhu, Department of Otolaryngology, Department of Head and Neck Surgery, First People's Hospital of Jining City.

You are welcome! There is a difference between the diagnosis of a thyrohyoid cyst and a lymph node: a thyrohyoid cyst is a common neck mass.

It is generally located near the hyoid bone in front of the neck **, and is easy to be mistaken for the Adam's apple. During embryonic development, the thyroid gland descends from the base of the tongue through the thyrohyoid path to the lower part of the neck, which is the location of the thyroid gland. If the path is not completely closed, a cyst is formed.

The cyst moves up and down by swallowing or sticking out the tongue, and most people are asymptomatic.

Lymphadenitis: neck, submandibular and submental are easy to be misdiagnosed, acute lymphadenitis.

The lump is red, swollen and tender, and easy to distinguish. Chronic lymphadenitis: small ones are not easy to touch, but those that are touchable are generally soft and sliding, and there is no tenderness.

When encountering such a lump, pay attention to the hardness and tenderness? Mobility, adhesion or not? Whether there is redness, swelling, scarring, or fistula.

Do you have a primary lesion? Ancillary examinations: B-ultrasound, puncture cytology, not difficult to diagnose.

The former surgery is the best method. But be sure to remove it cleanly.