The morning had begun with a sniffly-nosed toddler, complaining of a sore throat. Her symptoms didn’t seem alarming. It was probably just allergies or a little cold; Nothing to worry about.
But two hours later, I was rushing my two-year-old to the emergency department with a swollen lump in her neck the size of a ping-pong ball.
After some testing and a sonogram of the affected area, doctors determined that the bulging mass in my daughter’s neck was a thyroglossal duct cyst.
While I had never heard of such a thing, a pediatric ear, nose and throat specialist told us that it was somewhat of a common anomaly in children.
In fact, Scott & White otolaryngologist Melissa G. Kress, DO, has had four cases of this type of cyst in her practice just since February, and explains why these cysts occurs.
How does a thyroglossal duct cyst form?
“When the thyroid gland forms in the womb, it forms at the back of the tongue and descends down the neck through the hyoid bone that is above the Adam’s apple,” Dr. Kress said. “The gland ends up in the neck, just above the collar bone on either side of the windpipe. If the tract persists, and there’s a connection, any infection of the throat could cause a cyst to happen.”
The tract allows bacteria and infection to enter through the throat and causes the neck to swell. This is especially true for kids who have recurrent tonsillitis.
The cyst that is formed from the inflamed neck can be anything from a little bump to a large, swollen mass that is secreting puss.
What are the signs and symptoms of this cyst?
A cyst will look like a small bump in the front of the neck where the Adam’s apple would be.
“It moves when the child swallows and goes up and down when they stick out their tongue,” Dr. Kress said. “It shows some attachment to the swallowing muscles and can go up and down when your child has a cold.”
Other symptoms of a thyroglossal duct cyst could be:
- Redness around the mass or in the front of the neck
- Mucus-like drainage coming from the front of the neck
- Trouble swallowing
- Painful swallowing
How is it treated?
“The only treatment is to surgically remove the cyst if you want to make sure there are no further complications down the road,” the doctor said.
There is a slight chance that the cyst could come back, but Dr. Kress said that Scott & White ENTs do everything they can to lower the risk of that happening.
“I will literally put my hand inside a child’s mouth and feel the back of the tongue and feel the front of the neck to make sure I’m where I need to be to get it out completely.”
The surgery only takes a couple of hours and the child should be back to normal activities within a week.
If you suspect that your child might have a thyroglossal duct cyst, make an appointment with your pediatrician. Your doctor will be able to determine if your child needs to be referred to a specialist.
