A 3-year old girl is posted for tonsillectomy. On examination it is found that she has a midline cystic swelling extending till below the hyoid bone. It is painless and moves with deglutition. The thyroid examination is normal. What should be done next?

This clinical presentation (midline neck cyst that moves with deglutition, extending below hyoid, normal thyroid gland) is classic for a thyroglossal duct cyst. These are embryologic remnants that can present in childhood. Surgical removal is the definitive treatment (Sistrunk procedure) to prevent recurrence and infection. Aspiration would lead to recurrence, and observation is inappropriate given the risk of complications. IV antibiotics are not indicated for an uncomplicated cyst.