THYROGLOSSAL-DUCT & CYST REMOVAL

General Information

DEFINITION-Removal of a thyroglossal duct that has a cyst. The cyst results from remnants of the thyroid gland that do not descend normally during early fetal development. The cyst usually appears during childhood, attached to the hyoid bone by the

duct. The duct then passes upward to its origin at the base of the tongue. Surgery is usually performed when the patient is between 6 and 10 years old.

BODY PARTS INVOLVED-Thyroglossal cyst; remnants of the thyroglossal duct; hyoid bone.

REASONS FOR SURGERY

• Prevention of infections.
• Relief of pressure on the airway that causes difficulty in breathing or swallowing.

SURGICAL RISK INCREASES WITH

• Obesity.
• Poor nutrition.
• Recent or chronic illness.
• Other congenital disorders.

What To Expect

WHO OPERATES-General surgeon or ear, nose and throat specialist (otolaryngologist).

WHERE PERFORMED-Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies.
• After surgery: Blood studies.

ANESTHESIA-General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made in the neck over the thyroglossal cyst.
• The cyst is cut free of muscle and connective tissue. The part of the hyoid bone to which the cyst is attached is cut, and the cyst and bone are removed.
• The thyroglossal duct is located, tied, cut and removed.
• The neck muscles are closed with fine sutures.
• The skin is closed with either sutures or clips, which usually can be be removed about 4 to 7 days after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Inadvertent injury to larynx (rare).

AVERAGE HOSPITAL STAY-2 to 4 days.

PROBABLE OUTCOME-Expect complete healing without complications. Allow about 6 weeks for recovery from surgery.

Postoperative Care

GENERAL MEASURES

• A hard, blunt ridge should form along the incision. As it heals, the ridge will recede gradually.
• Use an electric heating pad, a heat lamp or a warm compress to relieve incisional pain.
• The child should bathe and shower as usual, and wash the incision gently with mild unscented soap.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

ACTIVITY

• Return to normal activity as soon as possible to promote healing.
• Avoid vigorous exercise for 6 weeks after surgery.

DIET-Clear liquid diet until the gastrointestinal tract functions again. Then provide a well--balanced diet to promote healing.

Call Your Doctor If

Any of the following occurs:

• Increased pain, swelling, redness, drainage or bleeding in the surgical area.
• Nausea or vomiting.
• Signs of infection, such as headache, muscle aches, dizziness or a general ill feeling and fever.
• Hoarseness that doesn't go away within 2 weeks after surgery.