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Thyroglossal Duct & Cyst Removal

Last updated April 24, 2019

Approved by: Krish Tangella MD, MBA, FCAP

Freestock.com

Thyroglossal Duct and Cyst Removal is a surgical procedure that involves removing an abnormal mass or lump that has developed on the thyroglossal duct.


Background Information:

What are the other Names for the Procedure?

  • Sistrunk Procedure

What is Thyroglossal Duct & Cyst Removal surgical procedure?

  • A thyroglossal duct cyst is a congenital abnormal defect (present at birth) that is predominately removed from children between the ages of 6 and 10 years old
  • Thyroglossal Duct and Cyst Removal is a surgical procedure that involves removing an abnormal mass or lump that has developed on the thyroglossal duct

What part of the Body does the Procedure involve?

The Thyroglossal Duct and Cyst Removal procedure involves the thyroglossal cyst, leftover pieces of the thyroglossal duct, and hyoid bone. The thyroglossal cyst may occur anywhere from under the tongue, to the lower half of the neck.

Why is the Thyroglossal Duct & Cyst Removal surgical procedure Performed?

A Thyroglossal Duct and Cyst Removal procedure is performed for the following reasons:

  • Prevent the possibility of an infection
  • Alleviate abnormal pressure on the airway, making it difficult to breath or swallow

What are some Alternative Choices for the Procedure?

The fluid from the cyst may be removed using a needle to collapse the mass (needle aspiration). However, the cyst may eventually enlarge again following aspiration.

What are the Recent Advances in the Procedure?

There are no recent advances in the Thyroglossal Duct and Cyst Removal procedure.

What is the Cost of performing the Thyroglossal Duct & Cyst Removal surgical procedure?

The cost of Thyroglossal Duct & Cyst Removal procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused by the information regarding the Thyroglossal Duct and Cyst Removal procedure and on what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
  • They can also choose to approach another physician independently. Besides, if the procedure has many alternatives, the patient may take a second opinion to understand and choose the best one

What are some Helpful Resources?

Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5th Edition, New York, 2006

http://www.fauquierent.net/thyroglossalduct.htm (accessed on 05/16/2015)

http://www.chadkids.org/documents/pdf/Sistrunk_11-10.pdf (accessed on 05/16/2015)

Prior to Thyroglossal Duct & Cyst Removal surgical procedure:

How is the Procedure Performed?

The Thyroglossal Duct and Cyst Removal procedure may be performed under general anesthesia.

  • An incision is made on the skin of the neck over the area of the mass
  • After cutting through the underlying tissue layers, the cyst, the complete tract of the cyst up until the tongue tissue, and a part of a bone called the hyoid is removed
  • A small tube is kept in place temporarily to drain any fluid that may collect after surgery
  • The incision is closed in layers

Where is the Procedure Performed?

A Thyroglossal Duct and Cyst Removal procedure is performed in a hospital.

Who Performs the Procedure?

The Thyroglossal Duct and Cyst Removal procedure is performed by any of these medical personnel, with or without assistance from an anesthesiologist:

  • General surgeon
  • Otolaryngologist

How long will the Procedure take?

The procedure may take about an hour to perform.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the Thyroglossal Duct & Cyst Removal procedure and helps avoid unnecessary complications.

  • Provide a complete list of medications you are currently taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
  • If you are allergic to any specific medication or food items
  • If you are taking blood thinners such as aspirin, warfarin, herbal supplements, or any other such medications
  • If you or your family members have a history of bleeding disorders or if there is a tendency to bleed more than normal
  • If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
  • If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
  • If you have a history of frequent bone fractures (this may affect bone-healing if bones are involved as part of your procedure)
  • A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
  • Some medications increase a person’s chances of bleeding, and it may be recommended to discontinue them for a period of time before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Do inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
  • The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
  • For individuals suffering from diabetes, it is important that the blood sugar stays within the normal range; if not, their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines

What is the Consent Process before the Procedure?

A physician will request your consent for Thyroglossal Duct & Cyst Removal procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Procedure?

Before a Thyroglossal Duct and Cyst Removal procedure, the patient has to undergo certain tests (as directed by the physician) such as:

  • Routine blood and urine analysis
  • Ultrasound imaging
  • Computerized tomography (CT) scan

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

  • What is a Thyroglossal Duct and Cyst Removal procedure?
  • What does the removal procedure involve?
  • How will this procedure help?
  • Will the procedure in any way impair my mobility?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • Are there any complications after the procedure or during recovery?
  • How long will it take to recover? When can I resume normal work?
  • Are there any lifestyle restrictions or modifications required, after the procedure is performed?
  • Are there any follow-up tests or periodic visits to the healthcare facility required after the procedure?
  • How many such procedures have you (the physician) performed?
  • What are the costs involved?

During the Thyroglossal Duct & Cyst Removal surgical procedure:

What kind of Anesthesia is given, during the Procedure?

General anesthesia by injection and inhalation is administered prior to the procedure.

How much Blood will you lose, during the Procedure?

There is not much blood loss during an uncomplicated Thyroglossal Duct and Cyst Removal procedure (or Sistrunk Procedure).

What are the possible Risks and Complications during the Thyroglossal Duct & Cyst Removal surgical procedure?

There are general factors that increase the risk of getting complications during surgery and they include:

  • Obesity: Generally, the greater the degree of obesity, the greater the surgical risk
  • Smoking: The longer the smoking history (in pack years smoked), the greater the surgical risk
  • Advancing age
  • Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
  • Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
  • Poorly functioning liver, as evidenced by increased blood liver function tests
  • Hypertension (increased blood pressure), especially if it is poorly controlled
  • Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
  • Poor lung function, as evidenced by abnormal lung function tests
  • History of bleeding disorders
  • Longstanding illness such as autoimmune disorders or chronic infections
  • Poor immune system due to a variety of causes

The possible risks or complications that may arise during the Thyroglossal Duct and Cyst Removal surgery are:

  • Excessive bleeding
  • Infection within the surgical wound
  • Anesthetic complications
  • Accidental injury to the surrounding nerves
  • In rare cases, accidental injury to the larynx

What Post-Operative Care is needed at the Healthcare Facility after the Thyroglossal Duct & Cyst Removal surgical procedure?

At the healthcare facility, generally there is no requirement for any post-procedure care, unless any complications arise.

After the Thyroglossal Duct & Cyst Removal surgical procedure:

What are the possible Risks and Complications after the Thyroglossal Duct & Cyst Removal surgical procedure?

The possible risks and complications that may arise after the Thyroglossal Duct and Cyst Removal surgery are:

  • Excessive bleeding
  • Infection within the surgical wound

What is the Prognosis after the Surgery?

A complete recovery from Thyroglossal Duct and Cyst Removal procedure is usually achieved. The prognosis is excellent without any serious complications being observed.

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms:

  • Pain that worsens and swelling around the surgical wound
  • Bleeding or fluid drainage within the surgical wound
  • The occurrence of any symptom that causes uneasiness such as nausea or vomiting
  • If the child has difficulty making vocal sounds when speaking (hoarseness)
  • If the child has difficulty breathing
  • Signs of an infection
  • Headache, muscle aches
  • Dizziness
  • Fever, feeling sick
  • Complications associated with prescription medications used in treatment

What Post-Operative Care is needed at Home after the Thyroglossal Duct & Cyst Removal surgical procedure?

At home, the following post-operative care is recommended after Thyroglossal Duct and Cyst Removal procedure:

  • Slowly resume regular/daily activities as early as possible, which aids in a faster recovery
  • Use a heat pad or warm compress to relieve pain due to the incision
  • The child should resume showering or bathing, keeping the wound clean and dry. Gently wash the surgical wound with mild unscented soap
  • Replace the dressing after showering
  • Complete the course of prescribed medication or advised by the physician
  • Take antibiotic medication to help combat or prevent infection
  • Avoid taking nonprescription medications such as aspirin. However, individuals may take acetaminophen to relieve pain, per the physician’s advise
  • Avoid all activities that are physically strenuous for about 3 weeks after surgery
  • The child is advised to have to clear liquids immediately after surgery, until the gastrointestinal tract begins properly functioning. Then, he/she may proceed to eat a well-balanced diet, which can aid in a faster recovery

How long does it normally take to fully recover, from the Procedure?

It usually takes approximately 6 weeks to fully recover from this procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The tissue is taken for further examination and later disposed, as per the standard medical procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

  • The tissue removed is processed in the laboratory under a pathologist's supervision
  • Slide(s) are prepared once the tissue is processed and this is examined by a pathologist and a pathology report issued
  • Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time

Who will you receive a Bill from, after the Thyroglossal Duct & Cyst Removal surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • A hospital
  • An anesthesiologist (if anesthesia was administered)
  • A pathologist
  • General surgeon, otolaryngologist

The patient is advised to inquire and confirm the type of billing, before the Thyroglossal Duct and Cyst Removal procedure is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: May 27, 2015
Last updated: April 24, 2019