Congenital Anatomic Defects of the Head and Neck

1. TGDC: Thyroglossal Duct Cyst
2. Branchial Cleft
3. Cystic Hygroma

Compare by Location, Etiology, Age, Presentation, Treatment

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Location

1. Midline
2. lateral, anterior
3. lateral, posterior

Etiology

1. thyroglossal tract remnant
2. 2nd branchial arch most common
3. lymphangioma

Age

1. bimodal: 2-3 yrs & teens
2. first decade of life
3. first year of life

Presentation

1. painless, asymptomatic, elevates with protrusion of the tongue, presents w/ inflammation
2. cysts, sinuses, fistulas, presents w/ inflammation in childhood
3. soft, diffuse, nontender, may transilluminate, increase w/ crying

Treatment

1. abx, thyroid scan, complete excision
2. abx, complete excision
3. CXR. may resolve, may need excision

CHLA Board Review 2005