A 6-year-old boy has a 2 cm midline neck swelling at the level of the hyoid that moves on swallowing and on protrusion of the tongue. Ultrasound confirms a cystic lesion separate from the thyroid. What is the definitive surgical procedure?

• A Excision of the cyst alone
• B Cyst aspiration and sclerotherapy
• C Sistrunk procedure ✓
• D Total thyroidectomy with central compartment dissection

Explanation

This is a thyroglossal cyst, the commonest congenital midline neck swelling in children. Definitive treatment is the Sistrunk procedure, which removes the cyst along with the body of the hyoid bone and the tract up to the foramen caecum, because the cyst communicates with the tongue base through a patent thyroglossal duct. Excision of the cyst alone carries a high recurrence rate, which is the fact that kills option A.

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.