A 6-year-old boy presents with a 2 cm midline neck swelling that moves upwards on protrusion of the tongue. Ultrasound confirms a cystic lesion with no normal thyroid tissue in the orthotopic location. What is the definitive surgical treatment?
- A Sistrunk procedure: excision of the cyst, central hyoid bone, and tract to the foramen caecum ✓
- B Simple cyst excision
- C Hemithyroidectomy
- D Antibiotic therapy and observation
Correct answer: A. Sistrunk procedure: excision of the cyst, central hyoid bone, and tract to the foramen caecum
Explanation
The Sistrunk procedure is the definitive treatment for thyroglossal duct cyst. It excises the cyst, the central portion of the hyoid bone, and a core of tissue up to the foramen caecum to remove the entire thyroglossal duct tract. Simple cyst excision alone carries an unacceptably high recurrence rate (up to 50%) because the microscopic ductal tract persists.
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.