Introduction: Thyroglossal duct cysts account for approximately 70% of congenital neck abnormalities. Hoarseness of voice and the extension of the cyst into the larynx are very uncommon.Clinical Picture: We present a patient with a long history of a large thyroglossal cyst who developed progressive hoarseness of voice. The cyst had protruded into the larynx producing the appearance of a laryngeal neoplasm. Computed tomography (CT) clearly demonstrated the nature of the cyst and its encroachment into the larynx. Treatment: This was safely excised with a Sistrunk procedure and a temporary tracheostomy to maintain a secure airway, in view of the possibility of postoperative supraglottic oedema. Conclusion: Endolaryngeal extension of the thyroglossal duct cyst is rare. Evaluation of unusual large midline neck masses should include a CT scan. The intralaryngeal component of the cyst can be easily dissected off from the neighbouring structures during dissection in the Sistrunk procedure. A tracheostomy may be needed.
Thyroglossal duct cysts are the most common nonodontogenic cysts that occur in the neck. They can be complicated by infections and fistulae.
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