A Clinical Analysis of Pharyngeal Bronchogenic Cysts in the Pharynx of Children

Abstract

Objective: This study was designed to summarize the clinical characteristics, diagnosis and treatment of pharyngeal bronchogenic cysts in children to help in making the correct diagnosis and developing an appropriate treatment plan.Methods: The clinical data of 13 children with bronchogenic cysts in the pharynx, who were treated in otolaryngology head and neck surgery department between September 2013 and July 2019, were analyzed retrospectively. The clinical characteristics were evaluated, and the related factors for diagnosis and treatment were analyzed. Clinical characteristics and imaging features of three cases whose lesions located in the nasopharyngeal, oropharynx, and laryngopharyngeal were demonstrated.Results: All 13 children were male, the youngest being 4 days old, the oldest 6 years and 6 months, and the median age being 1 year and 4 months. Eight patients were diagnosed during a physical examination, and five patients visited the doctor with different degrees of upper airway obstruction. The mass was located in the nasopharynx in one patient, in the oropharynx in eight patients, and in the laryngopharynx in the other four patients. Computed tomography (CT) scanning, which is helpful for a topical diagnosis, showed a dense homogeneous mass. Electronic nasopharyngoscopy showed cystic masses of different sizes in the pharynx. All the children underwent cyst resection under general anesthesia, and the postoperative pathology result was a bronchogenic cyst. One child was lost to follow-up, but the remaining 12 children were followed up for between 6 months and 6 years, during which no recurrence of a cyst was found.Conclusion: Bronchogenic cysts are a rare cyst of the head and neck, and the most common site of the cyst is the oropharynx. The impact on airway obstruction depends on the location and size of the cyst. CT scanning is of great significance for diagnosis. Surgical treatment should be carried out as soon as possible after diagnosis, as surgery is the most effective way to treat bronchogenic cysts. Follow-ups should be carried out regularly to prevent cyst recurrence.

Pediatric bronchogenic cysts in the head and neck region: A study of 10 surgical cases and a review of the literature

“…CT showed round, tubular or strip-shaped abnormal the thyroid and air-containing ducts originating from the piriform fossa (23,24). It was difficult to distinguish this disease from other diseases by preoperative imaging alone (8). Therefore, histopathological examination is critical to the final diagnosis of BCs (3,4,8,25).…”

“…BCs in the head and neck region are usually asymptomatic cystic lesions, and most cases are found during physical examinations ( 8 ), unless they are large enough to cause compression of the surrounding tissue or secondarily infected ( 9 ). In some individuals, large cysts may cause respiratory distress, wheezing, cough, dyspnea, and dysphagia ( 8 ). If the cyst is shallow, it may lead to sinus formation and external drainage of pus.…”

“…Therefore, the location of BCs cannot be used to make a final diagnosis ( 3 ). Due to the low incidence rate, the rates of misdiagnosis and missed diagnosis are high preoperative ( 8 ). The differential diagnosis of BCs in the head and neck region contains TGDC, branchial cleft cyst, lymphangioma, dermoid cyst/epidermoid cyst, cervical thymic cyst, and thyroid cyst ( 3 , 10 ).…”

“…It was difficult to distinguish this disease from other diseases by preoperative imaging alone ( 8 ). Therefore, histopathological examination is critical to the final diagnosis of BCs ( 3 , 4 , 8 , 25 ). The wall structure of BCs is the same as that of bronchial wall.…”

Subdiaphragmatic bronchogenic cysts: Case series and literature review

“…They usually locate in the thorax, especially in the mediastinum ( 1 – 3 ). However, they can be found in various atypical locations along the developmental pathway of the foregut, ranging from the pharynx to the spinal canal ( 4 , 5 ). Bronchogenic cysts can occur infrequently below the diaphragm, with the majority located in the retroperitoneal space, particularly the left adrenal region.…”