Thyroglossal duct cyst

ALERT: Call 911 if your child is having problems breathing.

What is a Thyroglossal Duct Cyst?

• A thyroglossal duct (TGD) cyst is a soft lump on the front, center of the neck. Most often these cysts are found in children who are 2 to 10 years old.
• The cyst may move up and down when swallowing or when sticking out the tongue.
• The cyst may be red, swollen, tender or painful if it is infected. If this happens, please call us right away.
• It may drain mucus, like spit, through a small opening in the skin.

What caused it?

• The TGD cyst was there before your child was born. There is nothing you could t happens when the thyroid gland forms at the back of the tongue and moves down the neck. It moves through a tube called the thyroglossal duct. Normally, this duct goes away after the thyroid gland gets to the bottom of the neck.
• A TGD cyst forms when part of this duct stays behind. It can fill with fluid or mucus. It will then grow larger and may get infected.

How is it diagnosed?

Most TGD cysts can be diagnosed during a physical exam. A neck ultrasound or scan may be done see if there is thyroid tissue in the TGD cyst.  A swollen lymph node or other neck cyst can look like a TGD cyst.

How is it treated?

Surgery is needed to remove TGD cysts. This will prevent the cyst growing larger or getting infected.  Removing a cyst that is not infected is best. 

When TGD cysts become infected, antibiotics and surgery are needed. In surgery, the cyst is drained of infection then cut out. Infection and drainage of the cyst can make surgery harder.  It is rare but a cyst may come back if all of the tract is not removed. 

What do I need to know before my child's surgery?

Do not give your child Ibuprofen (for example also called Advil) or Aspirin for 2 weeks before surgery. 

You can give Acetaminophen (Tylenol) as needed. Do not stop any prescribed medicines without talking with your doctor. If your child is put on any medicine other than an antibiotic before surgery, please call our office.

Before surgery (continued)

• We try to schedule surgery as soon as possible. If you have not heard from us in 48 hours after meeting the surgeon, please call our office 414-266-6550.
• Surgery is best done when your child is healthy. If your child has signs of illness, call your child’s doctor or nurse right away. Surgery may be canceled if your child is ill or has a fever.

What do I need to know after my child’s surgery?

Most surgeries for TGD can be done safely as an outpatient surgery. This means your child will not need to stay overnight in the hospital. 

Before going home after surgery your child will need to be:

• drinking enough fluids, like juice, water, or popsicles.
• feeling comfortable. 

What to expect

Pain

Your child may have mild pain for up to a week after surgery. Every child copes with pain differently. Give acetaminophen (Tylenol) and Ibuprofen as needed.  If your child has bleeding issues, do not give ibuprofen.

• Your doctor may prescribe a stronger pain medicine. This medicine is called a narcotic. Some narcotics have acetaminophen (Tylenol). If your child is taking a narcotic, check with your doctor before giving Tylenol.
• If your child needs more pain medicine, call the nursing line at (414) 266-6421. After hours call (414) 266-2000. Ask to have the Pediatric Surgery doctor on call paged.

Be sure to follow the directions on the bottle label of all medicines you give your child.

Diet

• Your child may drink clear liquids when they are awake.
• They may begin to eat when they feel ready.

Wound care

• Your child will have a small cut or incision where the TGD cyst was taken out. Stitches are put under the skin. They will dissolve over the next few weeks. You will not need to have them taken out at the doctor’s office.
• After 48 hours, you may get the incision wet. Pat the area dry very well. Do not rub.
• Your doctor will let you know if you need to put anything over the cut (incision).  

Follow up care

If your child does not already have a post-op visit scheduled, call your doctor’s office. Your child needs to be seen in 3 to 4 weeks after surgery.

Bathing and swimming

Check with your child’s healthcare provider about when your child can take a bath and swim.

Activity

• Most children can return to regular activity within 1 to 2 days after surgery.  This includes going to school.
• Your surgeon will provide instructions about returning to sports activities.

ALERT: Call your child’s doctor, nurse, or the Surgery clinic if you have any questions or concerns or if your child has:

• A fever over 101°F (38° C).
• Redness, tenderness or swelling around the incision.
• Bleeding or has drainage around the incision.
• Vomiting or not drinking for 24 hours.
• A hard time swallowing or breathing.
• Special health care needs that were not covered by this information. 

For more health and wellness information check out Kids Health.