Thyroglossal Cyst Cystic swelling developed in the remnant of the thyroglossal duct or tract Present in any pa of the thyroglossal tract (extends from foramen caecum to isthmus of thyroid) Common sites Subhyoid (MC) Floor of mouth Region of thyroid cailage Suprahyoid Beneath the foramen caecum Clinical features It is a midline swelling, except in the region of thyroid cailage, where thyroglossal tract is pushed to one side, usually to the left Though its a congenital swelling MC age of presentation is between 15 and 30 years Cyst can be moved sideways but not veically Peculiar characteristics which helps in distinguishing thyroglossal cyst from other neck swelling Moves up with protrusion of tongue as the thyroglossal tract is attached to the tongue Moves with deglutition so do all thyroid swellings, subhyoid bursitis Cyst is lined by pseudostratified columnar epithelium and squamous epithelium with hetero topic thyroid tissue present in 20% of cases Complications Recurrent infections Formation of thyroglossal fistula Carcinomatous change (papillary carcinoma) Treatment Sistrunk operation : En-bloc cystectomy and excision of central hyoid bone to minimize recurrence Ref: Sabiston 20th edition Pgno :1861