This is an automatically translated article.
Thyroid cyst is the most common mid-neck congenital malformation, related to the existence of the thyroid duct. During the formation of the thyroid gland, if the thyroid duct does not disappear and persists after birth, it will cause a thyroid cyst of the tongue.
1. What is a thyroid cyst?
Thyroid cyst is a congenital malformation, formed by the process of thyroid gland moving forward and downward in the neck area in the fetal stage. If this process does not take place normally, it will lead to the formation of a thyroid cyst.
In the normal person, the thyroid duct is hypoplastic and disappears around the 7th week of fetal development. In case the thyroid duct does not disappear and persists after birth, it will cause malformations.
Thyroid cysts can be found anywhere in the thyroid duct, from the foramen at the base of the tongue to the pyramidal lobe of the thyroid gland. Usually there is only one thyroid cyst, but occasionally several independent cysts may be found along the path of the thyroid duct. The fluid contained in the cyst is usually clear mucus.
2.Symptoms of Tongue Thyroid Cysts
Trường hợp u lớn có thể chèn ép đường thở làm bệnh nhân khó thở
The location of the thyroid cyst is usually in the midline, in front of the neck, at the level of the hyoid bone. Thyroid cyst is a round mass, containing clear mucus inside, moves with the patient's swallowing movement and does not cause pain. Thyroid cysts can cause a number of functional symptoms such as:
Swallowing disorders: difficulty swallowing, difficulty swallowing... Voice disturbances: voice entrapment. If the tumor is large, it can compress the airways, making it difficult for the patient to breathe. However, with vague and specific symptoms, thyroid cysts can be diagnosed incidentally or mistakenly for glottis fossa cyst.
Some tests to help diagnose thyroid cysts include:
Neck ultrasound: valuable to help diagnose but not completely accurate CT scan of the neck: very valuable in diagnosing thyroid cysts, tissue accurately describe the location, size and guide the surgical treatment direction later.
3. How to treat thyroid cysts?
Since 1920, Sistrunk, based on Wandlowski's embryology studies, recommended hyoidectomy, removal of cysts and thyroid fistulas. His surgical approach has greatly reduced the recurrence rate.
Sistrunk surgical procedure:
General anesthesia through endotracheal tube. Incision of the skin across the neck just above the tongue cyst. Softly dissected to reveal the cyst and hyoid bone, releasing as a mass. Most cysts will have a fistula into the hyoid bone, to the base of the tongue. Dissect until the probe line is about 5mm, then thread and cut the probe line. Sew back the cut muscle, if any. Place drainage and close the skin.
4.Complications of thyroid cyst surgery
Cần kháng sinh dự phòng khi vết mổ bị nhiễm trùng
Infection of the incision: it is necessary to use prophylactic antibiotics, if during surgery, the oropharyngeal mucosa is torn, it is necessary to sew recovery and place a feeding tube for a few days. Hematoma: occurs on the first day after surgery. If the hematoma is large, it will cause pressure on the patient to suffocate, it is necessary to reopen the incision, remove the blood and stop the bleeding. Injury to the superior laryngeal and hypoglossal nerves: very rare. Recurrence after surgery: in the form of cysts or fistulas, often due to incomplete surgery (ignoring hyoidectomy, failure to remove the entire cyst and fistula...). Perforation of the lower pharynx during dissection to remove the tumor, should be sutured to restore. Vinmec International General Hospital is a high-quality medical facility in Vietnam with a team of highly qualified medical professionals, well-trained, domestic and foreign, and experienced.
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