A thyroglossal fistula usually presents as a discharging orifice in the midline of the neck in the line of thyroid descent. It is never congenital but follows infection or inadequate removal of a thyroglossal cyst.
Presentation is with a fistulous opening near to the midline of the neck. The fistula may become infected and discharge pus.
The fistula should be excised along with the thyroglossal tract up to the base of the tongue. This requires removing the middle one third of the hyoid bone.
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