Getting Ready for Thyroglossal Duct Cyst Surgery

What is the Sistrunk procedure?

• A thyroglossal duct cyst is a pocket of fluid in the middle of the neck, left over from how the thyroid gland formed before birth.
• The Sistrunk procedure removes the cyst along with the middle part of the hyoid bone (a small bone in the front of the neck) and the tissue and tract that can connect the cyst to the base of the tongue. Removing all of this lowers the chance of the cyst coming back.
• A horizontal incision is made in the skin near the middle of the neck.
• The surgery is done under general anesthesia (completely asleep).
• For some people, sclerotherapy is an option instead of surgery: a medicine is injected into the cyst to shrink it. The most studied medicine for this is OK-432 (picibanil). The cyst is more likely to come back than after surgery.

What are the risks?

Every surgery has risks. Your surgeon will go over them with you before surgery, and you can ask about any of them.

• Anesthesia is safe, but it has some risks. The anesthesia team can go over them with you. Tell us if anyone in your family has had a problem with anesthesia.
• Pain, bleeding and infection are risks of any surgery.
• The cyst can come back, in about 1 to 5 in 100 people.
• Fluid collecting under the skin (seroma), which may need to be drained.
• Wound infection, which may need antibiotics.
• A scar where the incision was made. It usually fades over time.
• Injury to nearby structures, including nerves that affect feeling or movement of the tongue. This is uncommon.

How do I get ready?

• As soon as surgery is scheduled

  • Give us a list of every medicine, vitamin and supplement you (or your child) take. We will tell you which to stop and when.
  • If you smoke or vape, stop now: it helps healing and makes anesthesia safer. Keep children away from smoke and vaping.
  • Plan time off. Plan on 1 week off work or school.
  • Plan your travel. For 1 week after surgery, stay within about an hour of our office or an emergency room, and do not fly.
  • Arrange for an adult to drive you home. After general anesthesia, we recommend having an adult stay with you (or you and your child) the first night.

• 1 to 2 weeks before

  • Adults: aspirin is usually stopped 1 to 2 weeks before surgery. If you take aspirin or a blood thinner for your heart, a stent or stroke prevention, do not stop it on your own: your surgeon will check with whoever prescribes it.
  • Children: tell us if your child takes any medicine that thins the blood. Do not stop a prescribed medicine on your own.
  • Ask about herbal remedies and supplements, which can raise the chance of bleeding.
  • Get the supplies in the next section.

• The night before

  • Follow the eating and drinking instructions from our office or the surgery center exactly. Eating or drinking when you should not can mean surgery is postponed for safety.
  • For children: clear liquids are allowed up to 2 hours before surgery, breast milk up to 4 hours before, and formula or cow’s milk up to 6 hours before. All other food stops at midnight. Follow the exact times we or the surgery center give you.
  • Take only the medicines we said to take that morning, with a small sip of water.
  • Get a good night’s sleep.

• The day of surgery

  • Wear comfortable clothes. For children, a favorite blanket or toy can help.
  • Bring your photo ID, insurance card and list of medicines.
  • We will tell you your arrival time before the day of surgery. It is usually about 1 hour before surgery.

What happens after surgery?

• Most people go home the same day.
• There may be a small drain next to the incision to collect fluid for 1 to 2 days. It comes out at the first visit after surgery.
• Plan on 1 week off work or school. No heavy lifting or strenuous activity for 2 weeks.

The Thyroglossal Duct Cyst Recovery Guide has everything you need after the procedure, including when to call us.

When should I call before surgery?