Enigma of True Thyroglossal Fistula

A 2-year-old male child reported to the pediatric otolaryngology clinic of Kalawati Saran Hospital, a tertiary care pediatric center attached to Lady Hardinge Medical College, New Delhi, with the chief complaints of discharging sinus in the midline for the past 1 year (Figure 1). There was a distinct history of ruptured cyst in the midline. The purulent discharge from the sinus was intermittent and resolved on taking antibiotics. On examination, the sinus opening was seen in the midline about 1.5 cm below the hyoid bone which moved with protrusion of tongue. A presumptive clinical diagnosis of thyroglossal fistula was made and ultrasound neck was done which showed a normal thyroid gland with no cystic lesion along the fistulous tract.