Superinfected nail thyroid cyst, how to treat?

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Thyroid cyst is the most common congenital disease among cervical cysts. If the disease is not treated promptly by surgery, it can cause many complications, the most important of which is the complication of superinfected thyroid cyst.

1. What is a thyroid cyst?

In congenital diseases of the neck region, thyroid cysts account for the highest proportion compared to other types of cysts. The main mechanism of thyroid cyst is the abnormality in the development and differentiation process to form organs in the head, face and neck region at the embryonic stage of the thyroid duct.
Accurate diagnosis of thyroid cyst pathology is relatively difficult, mostly based on vague symptoms of the disease, but rarely using testing facilities such as ultrasound, computed tomography... Therefore, the diagnosis of this pathology is easy to confuse with other types of cysts, often delay and easily lead to complications of superinfected thyroid cysts.
Diagnosis and treatment of thyroid cysts must be done in specialized hospitals to bring about high efficiency, thoroughness, and less complications... However, most patients are only treated in In lower-level hospitals, the understanding of the pathogenesis is incomplete, so the diagnosis and treatment with simple methods such as plastering, aspiration, incision, sclerotherapy or surgery are not thorough. often leave fistulas and infections.

2.Causes of thyroid cysts

In the fetal stage, there is a small tube called the thyroid gland that appears during the formation of the thyroid gland and connects to the tongue called the thyroid duct. Normally, the lingual thyroid duct will dissolve, atrophy, and disappear.
For some reason, the thyroid duct does not disappear but still exists, creating closed cysts located in the middle of the floor of the mouth, above or below the hyoid bone. This cyst develops gradually, causing a thyroid cyst (also known as a thyroid duct cyst).

3.What are the symptoms of a thyroid cyst?

A very typical and typical manifestation of thyroid cysts is that the patient appears a small lump the size of a marble or larger than a kumquat in the skin of the anterior neck, corresponding to the hyoid bone, attached to the hyoid bone. the deep part, the surface is covered with normal skin. This cyst moves with the rhythm of swallowing and feels tight to the touch but does not cause pain, when aspirated there is mucus inside.
If the thyroid cyst is not diagnosed and operated in time, it will cause a complication of a superinfected thyroid cyst, the cyst will burst with pus and mucus and cause a fistula to come out and discharge a lot of yellow fluid. This fistula may seal on its own or may cause inflammation around the fistula and cause severe pain.
Some thyroid cysts are atypical, rare, such as a cyst that changes size and causes swallowing difficulties, an infected and enlarged fistula or sometimes the cyst is not located in the mid-anterior neck region but on the side neck or cyst located in the thyroid gland.

4. Diagnostic test for thyroid cysts

A number of imaging techniques to help diagnose and differentiate thyroid cysts from other types of cysts in the neck region, evaluate complications as well as prognosticate and support the treatment of posterior thyroid cysts there.
Thyroid ultrasound Ultrasound is an easy-to-implement, highly reliable imaging tool for the differential diagnosis of thyroid cysts from other tumors in the anterior neck region. In addition, thyroid ultrasound also helps identify the types of thyroid cysts that recur after surgery and do not cause clinical symptoms as well as survey the accompanying thyroid lesions.
X-ray with contrast injection Injecting contrast agent into the cyst or fistula and then conducting X-ray to help provide more images about the relationship of the thyroid cyst, evaluate the fistula of the thyroid gland to the bone nail with adjacent anatomical structures.
Computed tomography CT scanner is a highly valuable imaging tool for neck tumors. Computed tomography of the neck will provide accurate information about cysts and cystic ducts in terms of features such as location, size, characteristics and relation to surrounding structures.

5. Complications of thyroid cysts

Thyroid cysts, if not treated promptly, can cause dangerous complications as follows:
Superinfected thyroid cysts cause swelling, heat, redness, pain and festering abscesses; Leakage of pus through the skin or into the throat area; Neck deformity causes aesthetic loss; Hypothyroidism ; Thyroid cyst cancer; Recurrence after thyroid cyst surgery.

6. How to operate thyroid cyst?

Currently, the only radical and highly effective treatment for thyroid cysts is surgery with the Sistrunk method. This method was first introduced in 1920. According to Gary and Josephson, Sistrunk surgery is the gold standard for thyroid cyst surgery.
Sistrunk surgery is performed by removing the entire cyst, the body of the hyoid bone, and about 3mm of tongue tissue around the upper hyoid bone of the thyroid duct to the foramen.
However, many cases of thyroid cyst surgery can fail due to many factors such as only performing thyroidectomy alone, without cutting the thin bone body... this is the main reason causing recurrence. development, this rate accounts for about 59-100%. If the thyroid cyst is only aspiration, dredging, cauterization, injection, incision, the recurrence rate is definitely 100%.
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