A thyroglossal cyst always lies in close relationship to which anatomical structure, and at what vertebral level does the hyoid bone develop during descent of the thyroid?

• A Lies anterior to and incorporates the body of the hyoid bone (C3 level); must include midportion of hyoid in Sistrunk operation ✓
• B Lies posterior to the larynx at the level of C5–C6 thyroid cartilage
• C Lies within the thyroid gland substance at the level of the isthmus
• D Arises from the third pharyngeal pouch and is always lateral to the midline

Explanation

The thyroglossal duct descends from the foramen cecum (junction of anterior two-thirds and posterior one-third of tongue, at the level of the junction of the 1st and 2nd pharyngeal arches) through or around the hyoid bone. Because the duct passes through or immediately anterior to the body of the hyoid bone during descent, thyroglossal cysts invariably have a close relationship to the hyoid at the C3 level. The Sistrunk operation (definitive treatment) requires excision of the cyst, the complete duct tract, and the central portion of the hyoid body — failure to remove the hyoid results in a 50% recurrence rate.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.