Thyroglossal Duct Cyst in Children

Thyroglossal duct cysts in children are congenital. It means your child is born with one. You can usually feel it through the skin at the middle of their throat. It will feel small and round. Sometimes, you can clearly see the fluid-filled lump moving up and down when your child swallows. Or maybe your pediatrician felt it during a checkup. Most thyroglossal duct cysts in children are diagnosed before kids are age 10.

These cysts are almost always benign, only rarely turning cancerous. But they can cause problems with swallowing (dysphagia). Or they can become infected and sore — and even rupture. A thyroglossal cyst won’t go away on its own. So, it’s important to find an experienced pediatric head and neck surgery team to remove it.

What to expect at your child’s first visit

When you come to your child’s first appointment, you’ll want to be prepared to answer a lot of questions about why you’re there. Your child’s provider will want to know about things like:

• When did you first notice the lump?
• How did you notice the lump?
• What does the lump feel like?
• Does the lump affect your child’s swallowing?
• Is the lump sore or swollen?
• Does the lump affect your child’s breathing?

During this visit, the provider will also give your child a physical exam to check out their overall health. They’ll take a close look at the outside of your child’s throat, too. They may lightly feel their throat and ask your child to swallow. And they may order tests to confirm a diagnosis.

Testing for thyroglossal duct cysts in children

Your child will likely get an ultrasound of their throat and neck. This helps our team see how big the cyst is, to confirm the diagnosis, and to make sure normal thyroid tissue is present. Our providers sometimes do other imaging tests like an MRI or CT scan. These tests create very detailed pictures of your child’s throat and the cyst.

Your child may also have a fine needle biopsy so we can see if the cyst has any cancer cells. About 99% of thyroglossal duct cysts in children aren’t cancerous.

Meet Our Thyroglossal Duct Cysts in Children Team

When your child comes to Cleveland Clinic Children’s for treatment, you can rest easy knowing they’re in good hands. They’ll have a personalized care team of expert pediatric providers from different specialties, like:

• Pediatric otolaryngologists.
• Pediatric radiologists.
• Pediatric pathologists.
• Pediatric anesthesiologists.
• Pediatric nurse anesthetists.
• Pediatric nurse practitioners.
• Child life specialists.

This team works together to confirm a diagnosis and build a carefully customized treatment plan for your child.

Your child’s treatment plan depends on how big the cyst is and how it affects their life. We may do watchful waiting. This means we’ll keep an eye on the cyst and see if it gets larger or infected. And if it does, we can start treatment quickly. Surgery is the main treatment for thyroglossal duct cysts in children.

Surgery for thyroglossal cysts in children

The most common type of surgery is Sistrunk surgery. Your child’s head and neck surgeon (otolaryngologist) will make a small incision in your child’s throat. Your child will be asleep from anesthesia, so they won’t feel any pain or discomfort when this happens. Once the surgery team has made the incision, they’ll remove the cyst and the thyroglossal tract (a tube connected to the gland). They’ll also remove the middle part of a bone in your child’s neck called the hyoid to keep the cyst from coming back.

After surgery, your child will go to a recovery area to wake up from anesthesia. Our team will keep an eye on them as they wake up. Usually, they can go home on the same day as their surgery. And they usually can go back to school about a week after it. We recommend they avoid strenuous activity for two to six weeks to make sure the area has fully healed.

This cyst is sent to our pathology lab to be examined. In the very rare chance we discover your child has thyroglossal duct cancer, we’ll talk with you about the next treatment steps. Again, this is quite rare. Treatments could include:

• Removing all or part of the thyroid (thyroidectomy).
• Removing any lymph nodes in their neck that the cyst might affect (lateral neck dissection).
• Taking radioactive iodine pills to kill any cancer cells.

Life After Treatment for Thyroglossal Duct Cysts in Children

In most cases, thyroglossal duct cysts in children don’t come back (recur). And if the cyst is cancerous, studies show about 95% of these cancers go away after surgery, too. Your child will have regular follow-up visits with their care team. Their providers want to make sure there aren’t any signs of recurrence. And if there are, they can start treatment right away.

Taking the Next Step

Finding a lump in your child’s neck and learning they need surgery can be unnerving. We understand that. But thyroglossal duct cysts in children are highly treatable and usually don’t grow back after expert treatment. At Cleveland Clinic Children’s, our otolaryngology team is here to make sure your child gets on the road to recovery as quickly as possible. So, they can get back to doing what they do best — being a kid.