Thyroglossal cust and fistual.pptx

Lecture notes for medical students

1. Tips on using my ppt. You can freely download, edit, modify and put your name etc. Don’t be concerned about number of slides. Half the slides are blanks except for the title. First show the blank slides (eg. Aetiology ) > Ask students what they already know about ethology of today's topic. > Then show next slide which enumerates aetiologies. At the end rerun the show – show blank> ask questions > show next slide. This will be an ACTIVE LEARNING SESSION x three revisions. Good for self study also. See notes for bibliography.

2. THYROGLOSSAL DUCT CYST

3. THYROGLOSSAL DUCT CYST Cystic swelling arising from embryological remnant of thyroglossal duct. It is regarded as tubulodermoid .

4. EMRYOLOGY

5. EMRYOLOGY Endodermal tissue in the floor of the pharynx foramen caecum ) (17th day of gestation). Cells of thyroid gland descend into the mesoderm into This communication is known as thyroglossal duct. It reaches its final position in the neck by the 7th week of gestation. The duct usually disappears by the 10th week of gestation.

6. Thyroglossal duct cysts are the most common congenital midline neck cyst

7. Clinical Features

8. Clinical Features Asymptomatic small mass in midline in front of neck Infected: tenderness, swelling & redness Fistula: Opening in skin with discharge of mucous from cyst Difficulty in swallowing or breathing Moves with swallowing and protrusion of tongue

9. Midline Swellings of the Neck

10. Inflammatory Reactive lymphadenopathy Thyroiditis S.cyst Neoplastic Thyroid Parathyroid Pharyngeal/laryngeal Lipoma Congenital Thyroglossal duct cyst Laryngocoele Dermoid cyst Infectious Ludwig’s Angina Midline Swellings of the Neck

11. Site of occurrence :

12. Site of occurrence : 1. Hyoidal - 60% 2. Suprahyoidal - 25% 3. Infrahyoid - 13% 4. Intralingual - 2%

13. Treatment

14. Treatment SISTRUNK OPERATION Involves exposing the whole cyst along with its tract. The anterior portion of the body of the hyoid bone should be included in the dissection to prevent recurrence

15. Thyroglossal cysts may become infected and rupture onto the skin of the neck presenting as a discharging sinus/fistula

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