Sternothyroid muscle cysts are uncommon fluid-filled sacs that develop near the sternothyroid muscle—a small, strap-like muscle found in the front of the neck. Although these cysts are rare, understanding them is important for early detection, accurate diagnosis, and appropriate treatment.
Anatomy of the Sternothyroid Muscle
Structure and Location
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Location:
The sternothyroid muscle is found in the anterior (front) part of the neck. It lies just below the thyroid cartilage (voice box) and runs vertically from the sternum (breastbone) upward toward the thyroid cartilage. This region is crucial because it overlaps with other muscles and structures involved in swallowing and breathing.
Origin and Insertion
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Origin:
The muscle originates from the back of the manubrium (upper part) of the sternum and the adjacent part of the first costal cartilage. -
Insertion:
It attaches to the oblique line of the thyroid cartilage. This positioning allows the muscle to play a role in moving parts of the larynx and thyroid cartilage.
Blood Supply
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Arterial Supply:
Blood to the sternothyroid muscle is supplied by small branches from arteries such as the inferior thyroid artery. This network of blood vessels ensures that the muscle gets enough oxygen and nutrients. -
Venous Drainage:
Veins in this area help drain blood away from the muscle, eventually merging with larger neck veins.
Nerve Supply
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Innervation:
The sternothyroid muscle is typically innervated by branches of the ansa cervicalis—a nerve loop in the neck. This nerve supply is crucial for muscle movement and coordination.
Key Functions
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Depressing the Thyroid Cartilage:
It helps lower the thyroid cartilage during swallowing, which is important for proper voice modulation. -
Assisting in Swallowing:
By working together with other neck muscles, it contributes to the smooth passage of food from the mouth to the esophagus. -
Stabilizing the Larynx:
It aids in maintaining the position of the larynx, which is essential for speech and breathing. -
Supporting Neck Movement:
The muscle helps in the overall movement and stabilization of the neck. -
Aiding in Breathing:
Indirectly, by helping position the laryngeal structures, it plays a part in efficient breathing. -
Protecting Nearby Structures:
Its location and firmness offer a degree of protection to underlying nerves, blood vessels, and other vital tissues in the neck.
Types of Cysts Related to the Sternothyroid Region
While true cysts within the sternothyroid muscle are rare, cyst-like lesions or developmental cysts can appear in the nearby region. Some common types include:
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Thyroglossal Duct Cysts:
Often found near the midline of the neck, these cysts form from remnants of the thyroglossal duct. -
Branchial Cleft Cysts:
These are congenital cysts that may occur along the side of the neck but occasionally can be found near the sternothyroid area. -
Inclusion Cysts:
Formed due to the inclusion of epithelial tissue, often following trauma or surgery. -
Lymphatic Cysts:
Related to abnormal development of lymphatic tissue, these cysts can present as swelling in the neck. -
Inflammatory Cysts:
Can occur following infection or inflammation in the neck region.
Understanding the type of cyst is crucial because it influences the management and treatment options.
Possible Causes of Sternothyroid Muscle Cysts
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Congenital Developmental Anomalies:
Errors during fetal development can lead to residual cystic structures. -
Thyroglossal Duct Remnants:
Persistent remnants can become cystic over time. -
Branchial Apparatus Anomalies:
Incomplete obliteration of branchial clefts can lead to cyst formation. -
Trauma:
Neck injuries can lead to inflammation and cyst development. -
Infections:
Bacterial or viral infections may cause localized inflammation that results in cysts. -
Inflammatory Conditions:
Chronic inflammatory processes can promote cyst formation. -
Autoimmune Reactions:
The body’s immune response may inadvertently cause cystic changes. -
Post-Surgical Changes:
Scar tissue and inclusion of epithelial cells after neck surgeries can lead to cysts. -
Iatrogenic Causes:
Medical procedures in the neck region might inadvertently cause cyst formation. -
Lymphatic Malformations:
Abnormal development of lymphatic vessels can result in cystic lesions. -
Cystic Degeneration of a Tumor:
Sometimes a benign tumor undergoes cystic changes. -
Hormonal Influences:
Hormonal imbalances affecting the thyroid and surrounding tissues might contribute. -
Obstruction of Glandular Ducts:
Blockage in ducts near the muscle can lead to fluid accumulation. -
Genetic Predisposition:
Family history of cystic neck lesions may increase risk. -
Environmental Toxins:
Exposure to certain chemicals might disrupt normal tissue development. -
Radiation Exposure:
Radiation to the neck region can lead to changes in tissue that predispose to cyst formation. -
Chronic Irritation:
Repeated mechanical or chemical irritation of neck tissues can cause cysts. -
Metabolic Disorders:
Certain metabolic conditions may influence tissue changes leading to cyst formation. -
Local Ischemia:
Reduced blood supply to the muscle may cause tissue breakdown and cystic spaces. -
Unknown Idiopathic Causes:
In many cases, the exact cause of the cyst remains undetermined despite thorough investigation.
Potential Symptoms
Cysts in the region of the sternothyroid muscle may be subtle or produce noticeable symptoms. Commonly reported symptoms include:
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Neck Swelling:
A visible or palpable lump in the front of the neck. -
Pain or Discomfort:
Localized pain around the cyst area. -
Difficulty Swallowing (Dysphagia):
A sensation of obstruction when swallowing food or liquids. -
Voice Changes:
Hoarseness or changes in the quality of the voice. -
Tightness in the Neck:
A feeling of tension or tightness, especially when the neck is moved. -
Redness or Warmth:
If the cyst becomes inflamed, the overlying skin may be red or warm. -
Cough:
Irritation from the cyst can sometimes trigger coughing. -
Sore Throat:
A persistent sore throat may be linked to an adjacent cyst. -
Difficulty Breathing:
In rare cases, a larger cyst can put pressure on airways. -
Swallowing Discomfort:
Mild to moderate pain when swallowing. -
Lump Sensation:
Feeling of a foreign body in the throat or neck. -
Neck Stiffness:
Reduced flexibility or stiffness in the neck muscles. -
Visible Bulge:
A bump that becomes more noticeable during swallowing or neck movement. -
Intermittent Pain:
Pain that comes and goes, often related to movement. -
Tenderness on Touch:
The area may be sensitive when pressed. -
Headaches:
Secondary tension headaches due to neck muscle strain. -
Difficulty Turning the Head:
Reduced range of motion if the cyst affects surrounding tissues. -
Fatigue:
General tiredness that might be associated with chronic inflammation. -
Numbness or Tingling:
In rare cases, if nearby nerves are irritated. -
Anxiety or Stress:
Concern about an unexplained lump can lead to psychological distress.
Diagnostic Tests and Procedures
When a cyst is suspected near the sternothyroid muscle, doctors may use one or more of the following tests to confirm the diagnosis:
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Physical Examination:
A thorough neck examination to palpate the lump. -
Ultrasound Imaging:
Uses sound waves to create images of the neck tissues and cyst. -
Computed Tomography (CT) Scan:
Provides detailed cross-sectional images of the neck. -
Magnetic Resonance Imaging (MRI):
Offers high-resolution images to differentiate soft tissue structures. -
Fine-Needle Aspiration (FNA) Biopsy:
Involves using a thin needle to collect fluid or tissue from the cyst for analysis. -
Blood Tests:
To check for signs of infection or inflammation. -
Thyroid Function Tests:
Assess thyroid hormone levels if thyroid involvement is suspected. -
X-Rays:
Occasionally used to evaluate bony structures and exclude calcifications. -
Radionuclide Scanning:
Helps determine thyroid tissue activity. -
Endoscopic Examination:
Using a small camera to look inside the throat and upper airway. -
Doppler Ultrasound:
Assesses blood flow around the cyst and in surrounding tissues. -
Histopathological Examination:
Microscopic analysis of the cyst wall and fluid (usually after surgical removal). -
Cytology Analysis:
Studies the cells from the aspirated fluid to check for abnormalities. -
Culture and Sensitivity Testing:
If infection is suspected, tests to identify bacteria and their antibiotic sensitivities. -
Elastography:
A specialized ultrasound that evaluates tissue stiffness. -
Contrast-Enhanced CT Scan:
Uses a contrast agent to better delineate structures. -
Positron Emission Tomography (PET) Scan:
Rarely used but can help assess metabolic activity if malignancy is a concern. -
Neck Lymph Node Evaluation:
Palpation or imaging to check for any enlarged nodes. -
Electromyography (EMG):
May be used to check the function of nearby nerves if nerve irritation is suspected. -
Molecular Testing:
In selected cases, genetic or molecular analysis may be conducted to rule out malignancy.
Non-Pharmacological Treatments
Non-drug treatments are an important part of managing cysts in the neck. Here are 30 options that can be used alone or alongside medical treatments:
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Observation and Watchful Waiting:
Monitoring small, asymptomatic cysts over time. -
Regular Follow-Up Examinations:
Periodic check-ups to monitor cyst size and symptoms. -
Neck Ultrasound Monitoring:
Repeat imaging to track changes in the cyst. -
Warm Compresses:
Applying gentle heat to reduce discomfort. -
Cold Therapy:
Occasionally, cold packs may reduce swelling if inflammation is present. -
Dietary Adjustments:
Eating a balanced diet to support overall health and reduce inflammation. -
Hydration:
Keeping well-hydrated to maintain tissue health. -
Stress Management:
Techniques such as mindfulness or meditation to reduce stress-related muscle tension. -
Physical Therapy:
Exercises to strengthen neck muscles and improve mobility. -
Posture Improvement:
Maintaining proper neck alignment to reduce strain. -
Neck Stretching Exercises:
Gentle stretches can alleviate tightness around the cyst. -
Massage Therapy:
A gentle massage may help relieve muscle tension. -
Acupuncture:
Some patients find relief through this alternative therapy. -
Yoga and Tai Chi:
Low-impact exercises that improve flexibility and reduce stress. -
Manual Lymphatic Drainage:
A specialized massage technique to improve lymph flow. -
Cervical Traction:
A physical therapy technique that gently stretches the neck. -
Heat Therapy Pads:
Use of electric heating pads designed for neck pain. -
Lifestyle Modifications:
Reducing activities that strain the neck. -
Avoidance of Heavy Lifting:
Preventing further strain on the neck muscles. -
Use of a Cervical Collar (Short-Term):
To provide temporary support during acute discomfort. -
Weight Management:
Maintaining a healthy weight to reduce overall bodily inflammation. -
Smoking Cessation:
Stopping smoking, as tobacco can slow healing and worsen inflammation. -
Proper Sleep Positions:
Using supportive pillows to maintain neck alignment during sleep. -
Hydrotherapy:
Warm baths or water therapy to relax neck muscles. -
Ergonomic Workstation Adjustments:
Ensuring that your computer or work environment supports good posture. -
Biofeedback Therapy:
Learning to control muscle tension and pain through relaxation techniques. -
Self-Massage Techniques:
Teaching simple methods to massage the neck safely. -
Education on Cyst Management:
Learning about the condition to reduce anxiety and stress. -
Alternative Therapies:
Exploring therapies such as herbal treatments (with professional guidance). -
Support Groups and Counseling:
Connecting with others for emotional support and shared experiences.
Drugs (Pharmacological Treatments)
While many cysts are managed without medication, drugs are sometimes used—especially if infection or inflammation is involved. Below are 20 medications that might be considered:
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Antibiotics (e.g., Amoxicillin):
To treat or prevent infection if the cyst becomes inflamed. -
Anti-inflammatory Drugs (NSAIDs):
Ibuprofen or naproxen may help reduce pain and swelling. -
Acetaminophen:
Used for pain relief. -
Corticosteroids (Oral):
To decrease inflammation in severe cases. -
Topical Antibiotics:
If superficial skin involvement occurs. -
Oral Corticosteroids:
In cases where inflammation is widespread. -
Antiseptics:
For cleaning and reducing infection risk during drainage. -
Pain Relievers:
Over-the-counter medications for mild pain management. -
Muscle Relaxants:
May be used if muscle spasms accompany the cyst. -
Antihistamines:
If allergic reactions contribute to inflammation. -
Fluoroquinolones:
In cases of resistant bacterial infections (prescribed with caution). -
Macrolide Antibiotics:
Such as azithromycin for patients allergic to penicillin. -
Cephalosporins:
Another class of antibiotics used as alternatives. -
Beta-Lactam Antibiotics:
Used when indicated by culture results. -
Antibiotic Creams:
For localized skin application around the cyst. -
Steroid Injections:
Direct injection to reduce localized inflammation. -
Leukotriene Receptor Antagonists:
In some inflammatory conditions, these may be considered. -
Antifibrotic Agents:
Under investigation for reducing scar tissue post-inflammation. -
Immunomodulators:
In rare cases, to help regulate an abnormal immune response. -
Proton Pump Inhibitors:
Although not directly treating cysts, these may be used if associated reflux contributes to throat discomfort.
Surgical Options
When cysts become problematic or do not respond to conservative treatment, surgery may be recommended. Here are ten surgical approaches that might be considered:
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Excisional Biopsy:
Surgical removal of the cyst for both treatment and diagnostic evaluation. -
Complete Cyst Excision:
Removal of the entire cyst to prevent recurrence. -
Drainage Procedure:
Minimally invasive drainage to relieve symptoms, often guided by ultrasound. -
Endoscopic-Assisted Surgery:
Uses a camera to improve precision during cyst removal. -
Sistrunk Procedure:
Specifically used for thyroglossal duct cysts, involving removal of the cyst and tract. -
Laparoscopic-Assisted Cervical Surgery:
Although rare in the neck, minimally invasive techniques can be used in selected cases. -
Robot-Assisted Surgery:
Advanced techniques to improve precision in delicate neck areas. -
Incision and Drainage:
Often used when the cyst is acutely infected, followed by further treatment. -
Cyst Marsupialization:
Opening the cyst to allow continuous drainage and healing. -
Reconstructive Surgery:
In cases where extensive tissue removal is necessary, reconstructive techniques help restore normal anatomy.
Prevention Strategies
Prevention can often help minimize the risk of developing cysts or complications related to them. Consider these ten prevention methods:
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Regular Medical Check-Ups:
Early detection through routine examinations. -
Maintain Good Neck Hygiene:
Cleanliness can help prevent infections. -
Avoid Neck Trauma:
Protect the neck during physical activities and sports. -
Prompt Treatment of Infections:
Early intervention can prevent the development of cysts secondary to infection. -
Manage Thyroid and Hormonal Disorders:
Regular testing and treatment can help maintain neck health. -
Healthy Diet and Hydration:
Supports overall tissue repair and immune function. -
Stress Reduction:
Techniques such as meditation or yoga can reduce muscle tension. -
Avoid Smoking:
Smoking impairs healing and increases the risk of inflammation. -
Ergonomic Work Environment:
Use proper posture and supportive equipment at work. -
Follow Medical Advice Post-Surgery:
Adhere to post-operative instructions to reduce the risk of recurrence or complications.
When to See a Doctor
It is important to consult a healthcare provider if you experience any of the following:
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Noticeable swelling or lump in the neck that does not go away.
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Pain or tenderness in the neck, especially when swallowing or moving.
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Difficulty breathing or a change in your voice.
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Persistent discomfort or a feeling of fullness in the throat.
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Signs of infection such as redness, warmth, or fever.
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Sudden changes in the size of a known cyst.
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Any concerns or anxiety about a lump in the neck.
Early evaluation helps rule out serious conditions and allows for appropriate treatment.
Frequently Asked Questions (FAQs)
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What is a sternothyroid muscle cyst?
It is a fluid-filled sac that occurs near the sternothyroid muscle, often resulting from developmental, inflammatory, or traumatic causes. -
How common are these cysts?
They are relatively rare compared to other neck cysts such as thyroglossal duct or branchial cleft cysts. -
What causes these cysts?
Causes range from congenital anomalies and infections to trauma and post-surgical changes. -
What symptoms should I look for?
Common symptoms include a visible lump, neck pain, difficulty swallowing, and sometimes changes in your voice. -
How is the cyst diagnosed?
Diagnosis is based on physical examination, imaging tests (like ultrasound or CT scans), and sometimes a biopsy. -
Are there non-surgical treatments available?
Yes, many cysts can be managed with observation, physical therapy, and other non-pharmacological methods. -
When is surgery recommended?
Surgery is considered when the cyst causes significant symptoms, recurrent infections, or if there is any concern about malignancy. -
What does surgical removal involve?
It may involve complete excision of the cyst or specialized procedures like the Sistrunk operation if a thyroglossal duct cyst is involved. -
Can these cysts come back after treatment?
Recurrence is possible, especially if the underlying tract or cause is not completely removed. -
What drugs might be used for treatment?
Antibiotics, anti-inflammatory medications, and occasionally corticosteroids are used if infection or inflammation is present. -
What non-pharmacological treatments help?
Warm compresses, physical therapy, and lifestyle changes like stress reduction and proper posture can help manage symptoms. -
How do I prevent complications?
Regular check-ups, early treatment of infections, and following post-treatment instructions are key. -
Is there a genetic predisposition?
In some cases, there may be a familial pattern, though most cysts are sporadic. -
What is the recovery time after surgery?
Recovery varies with the type of surgery, but many patients return to normal activities within a few weeks. -
Who should I consult if I find a lump in my neck?
An otolaryngologist (ENT specialist) or a head and neck surgeon can provide the appropriate evaluation and treatment.
Conclusion
Understanding sternothyroid muscle cysts involves knowing the basic anatomy of the neck, recognizing the various types of cysts that can occur, and being aware of the possible causes, symptoms, and diagnostic tests. Treatment may range from non-pharmacological methods—like lifestyle changes and physical therapy—to drugs and, in some cases, surgery. If you notice any concerning symptoms, it is important to consult a healthcare provider promptly.
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.
The article is written by Team Rxharun and reviewed by the Rx Editorial Board Members
Last Update: April 07, 2025.