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Dear Editor, The thyroid gland develops around the 3rd week of gestation. It originates at the base of the tongue (foramen caecum) and then it descends caudally to its normal position in the neck anterior to the trachea. During its migration, the thyroid tissue (pyramidal lobe) remains connected to the base of the tongue via an epithelial-lined tube known as thyroglossal duct. During the 5th–8th week of gestation, the thyroglossal duct loses its luminous and completely obliterates. Failure of normal obliteration of this migrating tract of the thyroid gland leads to cyst formation, these cysts appear in any position along the thyroglossal duct, and it represents the most common congenital midline cervical cystic mass in children and young adults.[1] The incidence of this developmental abnormality may be as many as 7% of the population.[2,3] Patients with thyroglossal duct cysts usually present with a midline cystic mass that moves with swallowing and tongue protrusion. Cysts may become infected by oral bacteria, usually Staphylococcus aureus, leading to sinus formation secondary to spontaneous rupture or surgical drainage of the cyst abscess.[4]

Modified sistrunk operation of thyroglossal Cyst–Fistula