Thyroglossal duct and other congenital midline cervical anomalies
Section snippets
Thyroglossal duct remnants
Thyroglossal duct cysts are among the most common congenital neck masses, occurring at least as frequently as branchial cleft anomalies. They are the most common midline cervical anomaly encountered in children.1, 2, 3
Dermoid cysts
Dermoid cysts account for up to 25% of midline cervical anomalies. These inclusion cysts are lined by epithelium and differ from epidermoid cysts in that they contain some evidence of epithelial appendages, such as hair, hair follicles, or sebaceous glands within the cyst wall.5, 44 The fact that these lesions typically occur along embryonic lines of fusion suggests that they exist as the result of entrapment of epithelial elements during development.
Ranula
Ranulae are uncommon midline cervical cysts caused by obstruction of one of the sublingual salivary ducts.5, 45 Most of these lesions are superficial, and actually present as a painless, cystic swelling in the floor of the mouth. With enlargement, superficial lesions may cause significant tongue deviation and hinder speech. Although extremely rare, a ranula may penetrate deep to the mylohyoid muscle, into the fascial planes of the neck. These “plunging” lesions may present only as an upper
Midline cervical clefts
Congenital midline cervical clefts are rare. They usually are noted at birth as a cutaneous ulceration with an overhanging skin or a cartilaginous tag in the low midline anterior neck5, 45, 46, 47 (Figure 3). There is usually a sinus tract protruding downward from the cutaneous component, which in complete clefts may make connection with the sternum or mandible. Alternatively, the external skin tag may cover a short sinus that ends in a blind pouch.45, 46 Microscopically, the sinus tract
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