- What is it
- Thyroglossal cyst, duct and partial hyoid resection (pyramidal lobe)
- When
- Once infection has settled down
- Rationale
- Operate on all
- Get recurrent infection
- Particularly if they’ve had one bout already
- Risk of malignancy
- Goals
- Complete excision of thyroglossal duct tract up to base of tongue
- Superior and posterior to hyoid bone
- Procedure
- Setup - GA/IVabx, supine, shoulder roll, head ring, stand on right
- Steps
- Transverse incision over cyst
- Subplatysmal flaps
- Dissect cyst
- Identify thyroglossal duct (posterosuperior to cysts)
- Follow and mobilise duct until hyoid bone is reached
- Divide muscle on sup and inf aspects of hyoid bone (diathermy)
- Transect central hyoid bone with cutter 1-1.5cm
- Continue duct dissection to floor of mouth
- Depress tongue with hand in mouth to help
- Ligate and transect duct at foramen caecum with vicryl
- Layered absorbable closure