Thyrohyoid cyst excision

The thyroglossal cyst is also known as the median cyst in the neck. It is produced during the thyroid gland, and the thyroglossal duct is not degraded or completely degraded. Small cysts located above the hyoid bone can be asymptomatic. When the cyst enlarges, there is swelling in the tongue, foreign body sensation in the pharynx, and unclear pronunciation. A circular bulge is seen at the root of the tongue. Cysts located below the hyoid bone and in front of the periosteum of the thyroid tongue are more common. The patient often has no obvious symptoms. It can be seen that there is a semi-circular bulge under the skin of the neck. The surface is smooth, tough and elastic, and has no adhesion to the skin. It can move up and down with swallowing. Puncture cysts can be used to extract translucent or turbid, thick and viscous liquids. It can occur from any point between the blind hole of the tongue and the incision on the sternum. It is closely related to the hyoid bone. It can often form a fistula after secondary infection. Therefore, it is advisable to perform surgery as soon as possible, and it is feasible to remove the thyroid gland cyst. Treatment of diseases: thyroglossal cysts and fistulas Indication The thyroglossal cyst should be surgically removed, and it is generally appropriate for surgery over 1 year old. If the abscess is formed, the drainage is first cut, and the operation is performed after the infection is controlled to form the fistula. Contraindications 1, with systemic diseases, can not tolerate surgery. 2, local infection, not suitable for surgery. Preoperative preparation Antibiotics are routinely used before surgery. Surgical procedure 1. The patient is supine, under the shoulder pillow, and the head is reclined. 2. Incision: In the most uplift of the cyst, the cis skin is made into a transverse incision. If there is a fistula, a transverse fusiform incision is made around the fistula to separate the upper and lower epithelium. 3. Exposure of the cyst and separation of the fistula: longitudinal separation of the thoracic and lingual muscles, exposing the cyst capsule. In order to determine the stroke and depth of the fistula, inject the methylene blue into the fistula or cyst, and use the tissue forceps to grasp the skin opening of the cyst or fistula to separate the hyoid bone. During the operation, care should be taken not to damage the laryngeal nerve and blood vessels. 4. Remove the middle part of the hyoid bone: When separating the hyoid bone, carefully check whether the blind end of the tube ends here. If it stops here, cut the fistula together with the cyst. If the pipe rises around the hyoid bone, it should be cut at 0.7 to 1 cm on both sides of the midline of the hyoid bone to remove the hyoid bone of 1.5 to 2 cm in length. Cut the hyoid bone muscle along the midline and separate the tongue from the deep part of the tongue to the base of the tongue. At this time, the forefinger extends into the entrance and pushes the blind hole of the tongue to the front and down. A protruding point can be seen behind the surgical field. At this time, the fistula is cut off at the end point of the fistula, and the defect in the blind hole is sutured by the gut. 5. Slot the incision layer by layer and place the rubber drain strip. complication 1. Recurrence: The recurrence rate of cyst or fistula resection is 3% to 4%. In 1999, the author reported that 110 cases of thyroid hyoid cyst recurrence were related to different surgical procedures. Only the thyroid sac cyst was removed without resection of the hyoid bone. 33.3% of the patients had recurrence; the thyroid gland cyst and the hyoid bone were removed, and only 5.1% of the fistula was cut at 0.5 cm above the hyoid bone. The sinus of the fistula, hyoid bone and hyoid bone was combined with the surrounding muscle tissue. None of the patients who underwent high ligation had a recurrence. 2. Miscut ectopic thyroid: Before the suspected ectopic thyroid gland, routine thyroid radionuclide scanning should be performed to understand the location of the thyroid gland. If unconditional, the thyroid tissue of the normal thyroid gland should be carefully explored during surgery or preoperative B. Super, biopsy frozen sections should be taken when abnormal tissue is found during surgery; if ectopic thyroidectomy has been confirmed, it should be sliced into autologous transplantation into the neck or inner thigh muscle to relieve postoperative hypothyroidism. Degree, but still need oral thyroxine tablets for life. 3. Postoperative infection: postoperative antibiotics should be used with effective antibiotics to prevent infection.