What are the dangers of thyrohyoid cyst?

Thyroglossal duct cyst is actually caused by incomplete degeneration of the thyroglossal duct. If it is not treated in time, it can easily cause various harms to the patient's body, such as disease recurrence. The thyroid gland is an important secretory organ in our body. If the secretion of hormones is affected by such diseases, the impact on the body will be magnified, so friends must pay attention to it.

Surgical procedures

1. The patient lies on his back with a pillow under his shoulders and his head tilted back.

2. Incision: Make a transverse incision along the skin grain at the most raised part of the cyst. If there is a fistula, make a transverse shuttle-shaped incision around the fistula to separate the upper and lower skin flaps.

3. Expose the cyst and separate the fistula: Separate the sternohyoid muscle longitudinally to expose the cyst capsule. To determine the course and depth of the fistula, methylene blue is injected into the fistula opening or cyst, and the skin opening of the cyst or fistula is grasped with tissue forceps and separated toward the hyoid bone. During the operation, care should be taken not to injure the superior laryngeal nerve and blood vessels.

4. Resection of the middle part of the hyoid bone: When separating to the body of the hyoid bone, carefully check whether the blind end of the tract ends here. If so, remove the fistula and cyst together. If the tube goes up around the hyoid bone, it should be cut 0.7 to 1 cm on each side of the midline of the hyoid bone, removing 1.5 to 2 cm of the hyoid bone. Cut the hyoglossus muscle along the midline and separate it along the fistula to the deep part of the tongue to the root of the tongue. At this time, insert the index finger into the mouth and push the blind foramen of the tongue root forward and downward. A protrusion can be seen behind the surgical field. This is the end point of the fistula. Cut off the fistula and suture the defect at the blind foramen of the tongue with intestinal suture.

5. Suture the incision layer by layer and place a rubber drainage strip.

complication

1. Recurrence: The recurrence rate of cyst or fistula resection is 3% to 4%. In 1999, an author reported that the recurrence of 110 cases of thyrohyoid cyst after surgery was related to different surgical procedures. 33.3% of the cases with only thyrohyoid cyst resection without hyoid bone resection had recurrence; 5.1% of the cases with thyrohyoid cyst and hyoid bone resection and only fistula cut and ligated 0.5 cm above the hyoid bone had recurrence; no recurrence was found in the cases with fistula, hyoid bone, suprahyoid sinus tract and surrounding muscle tissue removed and ligated at a high position.

2. Mistaken removal of ectopic thyroid gland: When ectopic thyroid gland is suspected before operation, thyroid radionuclide scanning should be performed routinely to understand the location of the thyroid gland. If conditions are not met, the thyroid tissue in the normal thyroid gland area should be carefully explored during operation or B-ultrasound should be performed before operation. When abnormal tissue is found during operation, biopsy and frozen section should be performed. If it is confirmed that the ectopic thyroid gland has been removed, it should be immediately cut into thin slices and autologously transplanted into the neck or inner thigh muscles to reduce the degree of hypothyroidism after operation, but oral thyroid hormone tablets are still required for life.

3. Postoperative infection: Effective antibiotics should be used in time after surgery to prevent infection.