A 6-year-old boy has a midline neck swelling that moves on swallowing and protrusion of the tongue. It was recently infected and drained. The reason recurrence is common after simple excision of the cyst is that the operation must also remove:
- A The pretracheal lymph nodes along the tract
- B The pyramidal lobe of the thyroid
- C The central portion of the hyoid bone and the tract up to the foramen caecum ✓
- D The thyrohyoid membrane
Correct answer: C. The central portion of the hyoid bone and the tract up to the foramen caecum
Explanation
A thyroglossal cyst arises from remnants of the thyroglossal duct, which passes through the body of the hyoid bone to reach the foramen caecum at the tongue base. Simple cyst excision leaves duct epithelium within and behind the hyoid, giving recurrence rates around 50 percent. The Sistrunk procedure removes the cyst, the central third of the hyoid, and the entire core of tissue up to the foramen caecum, reducing recurrence to under 5 percent.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.