Median neck cyst

A median neck cyst is a congenital malformation that is usually located in the midline of the neck at the level of the hyoid bone, i.e. between the chin and the larynx, and appears as a swelling or very rarely as an opening under the chin. The tissue in the cyst forms mucus, which is why the cyst gradually increases in size. The median neck cyst is usually characterised by a palpable or visible, non-painful swelling in the anterior midline of the neck. Bacteria can enter the cyst through the connection to the base of the tongue and lead to inflammation.

The median neck cyst is usually discovered by a non-painful swelling. If the cyst becomes inflamed, reddening of the skin in the area of the swelling is noticeable and pain and fever may occur. If the cyst is open, viscous fluid sometimes leaks out; if it is inflamed, this can also be pus.

The median neck cyst is diagnosed during the physical examination. An ultrasound is performed to confirm the diagnosis.

The median neck cyst does not regress. Due to the risk of inflammation and the associated more difficult surgical conditions and the increased risk of the cyst recurring after the operation, surgery is recommended at the time of diagnosis. The operation is performed via a small incision above the cyst. The cyst and its connection to the base of the tongue are removed. As the connection runs through the hyoid bone (a small transverse bone below the chin), part of the hyoid bone is also removed.

After the operation, you will be monitored and stay overnight in hospital to ensure that there is no bleeding in the operation area. Further follow-up checks will be carried out by your paediatrician.

Without surgery, there is a high risk that the cyst will become inflamed, making surgical removal much more difficult due to the inflammation. After surgery, the prognosis is very good. Complications such as inflammation or recurrence are rare.