Recurrent thyroglossal duct cyst presenting as upper airway obstruction: A case presentation and review of the literature

Abstract

Thyroglossal duct cysts are the most common congenital midline cervical masses in the pediatric population. Accurate preoperative diagnosis and subsequent adequate surgical excision are essential to prevent recurrence. The Sistrunk procedure is the surgical approach most often advocated. Although rare, treatment failure is most commonly attributed to the failure to perform adequate hyoid bone excision and dissection of the tract to the base of tongue. We report a case of a 7-year-old female who presented with airway obstruction 5 years after having had a Sistrunk procedure and excision of a lateral neck mass. Emergent tracheotomy and marsupialization of the base of tongue cyst were performed. After the diagnosis of recurrent thyroglossal duct cyst was established, core excision of the foramen cecum was performed transcervically when the cyst recurred a third time. The literature on recurrent thyroglossal duct cysts is reviewed and a discussion of its embryology, pathophysiology, epidemiology, presentation, treatment and prognosis is presented in an effort to increase awareness of this situation.