Neck Abscess After Thyroglossal Duct Cyst (TGDC) Surgery in a 2-Year-Old Girl

A Two-Year-Old Pateint Developed A Neck Abscess After Sistrunk Operation

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A Sistrunk Operation was performed in a different clinic with the diagnosis of a thyroglossal ductus cyst, and the patient applied to our clinic with complaints of having an abscess on the neck that started a few days after the operation. During the Sistrunk Operation, the cystic structure in the patient's neck, the middle part of the hyoid bone to which the tongue muscles of the cyst adhere, the middle part is surgically removed along with the tract section extending to the root of the tongue to minimize the risk of recurrence Nov. In the surgery reports of this patient, it was written that the classic S, strunk Operation was performed. However, a few days after the bandages were removed after surgery, abscess formation began to form in the patient's neck. In the photo on the side, it was taken immediately after the operation and there is only a very slight redness in the incision line. The dark areas are probably caused by the sticky parts of the patch that remain on the skin.

The photos on the below are from operation 3. and 4. they were taken a day later and show increased redness and swelling in the neck.

The photo above is 5. it was taken on the day and it is understood that the abscess formation in the neck has started.

The photos on the stage are from operation 7. and 9. they were taken after a day and show increased redness, swelling and abscess formation in the neck, followed by purulent material that drains out of the neck spontaneously.

After the abscess was drained spontaneously, the patient's fever, redness, and inflammation symptoms had all disappeared.

About 12% of all neck masses are congenital neck masses. The most common among these congenital masses is a thyroglossal duct cyst (TGDK) or fistula, which is seen in about 70%. TGDK occurs as a result of partial or complete non-closure of the thyroglossal duct while descending from the root of the tongue of the thyroid gland (foramen cecum) to normal neck anatomy in the fetus. If it opens into the skin of the neck, this condition is called a thyroglossal fistula. TGDK can be anywhere from the foramen cecum to the sternum. The most common residential areas are thyrohid (60%), suprahid (25%), suprasternal (13%) and intralingual (2%) regions. Rarely, cases with intrathyroid placement have also been reported. While it is usually located in the midline of the neck, in some cases it can also be located outside the midline.

The patient was scheduled for follow-up and re-operation after a pressured neck bandage, abscess drainage and antibiotic therapy.

Some Questions and Answers About Trioglossal ductus Cyst

What causes a thyroglossal ductus cyst?

The thyroglossal ductus, which normally forms during the embryonal development of the thyroid gland, completely closes after the transition of the thyroid gland from the root of the tongue to its normal anatomical location is completed. Here, thyroglossal ductus cysts are formed as a result of the failure of this channel to close from any level.

What happens if the thyroglossal cyst is not removed?

Cysts that are not removed are the cause of infection. The cause of the infection is the channel that has remained open. Cysts that are not surgically removed become infected and grow. They shrink or even disappear with antibiotic treatment.

Does a thyroglossal cyst cause pain?

A thyroglossal cyst is a movable, painless structure that contains a gelatinous secretion in it, located anywhere between the tongue root and the sternal notch in the midline of the neck. Dec. During upper respiratory tract infections, when the contents of the cyst become infected, they can cause symptoms in the form of a painful red swelling in the neck.

Is a thyroglossal cyst a cancer?

Thyroglossal cyst, detected in the middle structure of the neck, is called residual tissues that have developed into cysts. These masses, which are benign, are the most common congenital neck cysts. Rarely, malignant tumors may appear from within the cyst.

How does a thyroglossal ductus cyst occur?

The thyroglossal ductus(canal) is the canal that allows the development of the thyroid gland in the fetus in the mother's womb. If this channel does not close, these cysts may appear. The thyroid gland forms in the area of the foramen cecum at the root of the tongue, then migrates downwards through the thyroglossal canal, taking its final position.Thyroglossal duct cysts develop from the epithelial residue left as a result of insufficient closure (obliteration) of the thyroglossal duct between the foramen cecum and the thyroid gland and give signs as a Decumbent midline mass.

Treatment of thyroglossal cyst

The treatment of thyroglossal canal cyst is surgical removal. The operation is performed on uninfected cysts. If the cyst is infected, appropriate antibiotic treatment can be performed first.

Where is a thyroglossal cyst located?

A thyroglossal duct cyst is a round sac filled with fluid that usually occurs in the midline of the neck in children and young adults. The development of the thyroid gland begins at the root of the tongue at the back of the tongue while in the womb and ends with it descending downwards to its place at the entrance to the neck.

What is a thyroglossal fistula?

These lesions, which mostly occur as a mobile and painless swelling in the middle line of the neck, in the vertical direction during swallowing, can sometimes fistulize to the skin and are called thyroglossal fistula.

Source links >> Thyroglossal Duct Cyst - StatPearls - NCBI Bookshelf (nih.gov) / Microsoft Word - 112-118 doc.doc (dergipark.org.tr) / Thyroglossal Duct Cyst: What Is It and How Does It Impact Your Health? (webmd.com)

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

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