A 10-YEAR-OLD GIRL was referred to us for surgical evaluation of an asymptomatic cystic nodule in the upper midline neck that had been present for 2 months. The nodule was noticed by her mother when the child was looking at the ceiling. The child was otherwise healthy with no signs or symptoms of thyroid disease. On examination, the nodule measured approximately 1.5 cm in diameter and was closely associated with the hyoid bone. The nodule was not very mobile to manipulation, but moved freely with tongue motion. The thyroid gland was palpably normal and there was no cervical adenopathy. Thyroid function test results were normal. Presumptive diagnosis was a thyroglossal duct cyst. A standard Sistrunk procedure was done with excision of the cyst in continuity with the mid portion of the hyoid bone. Postoperative healing was uneventful.