If there is a mass that is in the midline of the neck, anywhere from the chin right down to the sternum, especially one that has any drainage coming out of it, but sometimes, it is just a lump, what we think about is something called a thyroglossal duct cyst. Your thyroid gland which is a gland that is in your neck forms from something called the thyroglossal duct. It is actually a little opening at the back of the tongue, and as a baby develops inside its mother still, the thyroid glands comes down and descends to its normal position in the neck, and sometimes, that descent is not quite normal and it leaves behind a little connection that forms a little cyst that fills with fluid and makes a lump in the neck.
Now if there is a thyroglossal duct cyst, in other words, if there is a swelling in the midline, then we always recommend an operation—a thyroglossal duct cyst connect to a little opening in the back of the tongue and they have a high risk of getting infected and once they are infected, they are very difficult to operate on. So, if we can identify them before they are infected, we schedule an operation. It is called a Sistrunk procedure. We would take the cyst, remove it and follow it up to what is called the hyoid bone, a little bone high, a little bone high in the neck and take out the center of the hyoid bone which is where the track, the opening to the back of the tongue goes through.
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