A. Central portion of hyoid excised.
B. Sternothyroid muscle dissected.
C. Isthmusectomy with subtotal thyroidectomy.
D. Strap muscle of neck are dissected.
Ans;A. Central portion of hyoid excised.
The patient is suffering from Thyoglossal Cyst.
- It is congenital in origin.
- It is cystic swelling developed in the remnant of the thyroglossal duct or tract.
- Site – It may be present in any part of the thyroglossal tract (thyroglossal tract extends from foramen caecum to the isthmus of thyroid).
Common sites are:
- Subhyoid (most common) in the region of the thyroid cartilages,
- Suprahyoid in the floor of mouth
- Beneath the foramen caecum
- It is a painless midline swelling, except in the region of the thyroid cartilage, where the thyroglossal tract is pushed to one side, usually to the left.
- Mobility – Cyst can be moved sideways but not vertically
- Peculiar characterstic which helps in distinguishing thyroglossal cyst from other neck swelling – it moves up with protrusion of tongue as the thyroglossal tract is attached to the tongue.
- It also moves with deglutition so do all thyroid swellings, subhyoid bursitis, sublingual dermoid..
- Recurrent infection
- Formation of thyroglossal fistula.
- Thyroglossal cyst is congenital but thyroglossal fistula is never congenital. It follows infection or inadequate removal of a thyroglossal cyst.
- Carcinomatous change (usually Papillary carcinoma.)
- Excision of the thyroglossal cyst along with the track and the central part of body of the hyoid bone is the treatment of choice (Sistrunk’s operation)