Thyroglossal duct cysts are typically found in young children. They occur during fetal development as the thyroid gland descends from the base of the tongue into the lower part of the neck. In some individuals, the tract from decent of the thyroid gland into the neck remains and a cystic fluid filled sac forms attached to the distal end of the tract that runs from the base of the tongue midline into the neck. If left in place, these tracts and cysts can become infected, enlarge in size, and in some cases, become malignant. Resection is typically recommended via a Sistrunk procedure. This involves dissection of the cyst and the attaching tract from the lower neck to the base of the tongue. During this procedure, the central part of the hyoid bone is cut out and removed with the specimen tract. This is done to help ensure and lessen the chance that the cystic tract and cystic sac do not recur. The cyst and its accompanying tract are external to the airway and the airway is not entered during the procedure. Patients typically spend one night in the hospital or go home the same day and do not spend several days in the intensive care unit post-surgery. They are not permanently hoarse postoperatively unless a complication occurs.
Thyroglossal duct cyst medical expert witness specialties include pediatric otolaryngology, head and neck surgery, pediatric infectious disease, pediatric critical care, neonatology, neonatal nursing, (medical) genetics, radiology, and pediatric oncology.