Name of the Procedure:

Excision of Thyroglossal Duct Cyst or Sinus; Recurrent

Summary

This procedure involves the surgical removal of a thyroglossal duct cyst or sinus, which is a persistent lump in the neck. Recurrent means that the cyst has returned after a previous surgery.

Purpose

The procedure addresses thyroglossal duct cysts or sinuses, which can cause swelling, infection, or discomfort. The goal is to remove the cyst or sinus completely to prevent further recurrences and complications.

Indications

The procedure is indicated for patients who have recurrent or persistent thyroglossal duct cysts that have not been resolved with previous treatment. Symptoms may include a visible lump in the neck, difficulty swallowing, or frequent infections in the affected area.

Preparation

• Patients may need to fast for several hours before the procedure.
• Certain medications might need to be adjusted or stopped.
• Pre-operative assessments, such as blood tests and imaging studies (e.g., ultrasound or CT scan), are usually required.

Procedure Description

1. The patient is administered general anesthesia to ensure they are asleep and pain-free.
2. A small incision is made in the neck at the site of the cyst.
3. The surgeon carefully dissects and removes the cyst or sinus, including the tract that leads to the base of the tongue, if necessary.
4. Surrounding tissue is inspected and cleaned to ensure no remnants remain that could potentially cause recurrence.
5. The incision is closed with sutures, and a sterile dressing is applied.

The tools and techniques used include scalpels, scissors, suction devices, and sometimes a harmonic scalpel or laser.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

It is performed in a hospital operating room or a specialized surgical center.

Personnel

The surgical team usually includes:

• A head and neck or general surgeon
• An anesthesiologist
• Surgical nurses
• Possibly a surgical technician

Risks and Complications

• Common risks: infection, bleeding, and scarring.
• Rare risks: damage to surrounding structures such as nerves or the thyroid gland, recurrence of the cyst, or anesthesia complications. Complications are managed with medications, wound care, and sometimes additional surgery.

Benefits

The main benefit is the resolution of symptoms and prevention of recurrent infections. Improvement is often noticeable shortly after recovery from surgery.

Recovery

• Patients are typically able to go home the same day or the following day.
• Pain can be managed with prescribed medications.
• Instructions include keeping the incision site clean and dry, avoiding strenuous activity for a few weeks, and attending follow-up appointments to ensure proper healing.
• Full recovery usually takes 2 to 4 weeks.

Alternatives

Alternatives might include:

• Observation and monitoring if the cyst is not causing significant symptoms.
• Aspiration of the cyst, though this often has a high recurrence rate. Compared to excision, these alternatives may have a higher likelihood of recurrence but involve less immediate risk.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel pain. Postoperatively, they may experience mild to moderate pain, which can be managed with medication. Swelling and some discomfort are normal and should diminish over time. Regular follow-up with the surgeon ensures the healing process is progressing well.