title: Investigation prior to thyroglossal duct cyst excision.
abstract: BACKGROUND
  Investigation of the anterior midline neck lump has been debated over the years with little agreement on best practice. Thyroglossal duct cysts (TDCs) are the most common aetiology. A TDC may contain ectopic thyroid tissue, which may affect the decision to excise.
  
  
  METHODS
  A computerised survey was sent to a representative sample of UK-based ENT surgeons to determine current practice in investigation of presumed TDCs and the incidence of ectopic thyroid tissue.
  
  
  RESULTS
  Overall, 95% of those surveyed use ultrasonography, with 32% also arranging  thyroid function tests. Fifteen per cent had encountered absent normal thyroid tissue in the presence of a midline neck swelling. In 64% of cases this represented the only functioning thyroid tissue. Thyroid function tests were normal in all but two cases.
  
  
  CONCLUSIONS
  The results show  a significant change in practice over the last decade. All surgeons would arrange some form of investigation of a presumed TDC, with the vast majority using ultrasonography. Radioisotope scanning should only be used if the ultrasonography or thyroid function tests are abnormal. The incidence  of ectopic thyroid tissue in this survey was higher than previously calculated, with a 0.17% prevalence of midline neck lumps representing the only functioning thyroid tissue.
authors.affiliation: Northampton General Hospital NHS Trust, UK. jajoseph@doctors.org.uk
authors.forename: J
authors.initials: J
authors.lastname: Joseph
authors.forename: K
authors.initials: K
authors.lastname: Lim
authors.forename: J
authors.initials: J
authors.lastname: Ramsden
mesh_terms: D002983:Clinical Competence / Q000706:statistics & numerical data; D006801:Humans; D010036:Otolaryngology / Q000379:methods* / Q000706:statistics & numerical data; D011300:Preoperative Care / Q000379:methods; D011364:Professional Practice; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013955:Thyroglossal Cyst / Q000175:diagnosis / Q000601:surgery*; D013960:Thyroid Function Tests / Q000706:statistics & numerical data; D006113:United Kingdom