<prompt> Which is never a cause of thyroglossal fistula -Infection of thyroglossal cystInadequate removal of thyroglossal cystCongenitalNone of the above  <response>: A thyroglossal fistula usually presents as discharging sinus 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 Acquired conditionClinical Features Presentation is with a fistulous opening near to the midline of the neck The fistula may become infected and discharge pusTreatment The fistula should be excised along with the thyroglossal tract upto the base of the tongue. This requires removing the central middle one third of the hyoid bone. 