Nasopharyngeal branchial cleft cyst

Abstract

Second branchial cleft cysts are almost always located in the neck; thus, their presence in the nasopharynx is extremely rare. A 44-year-old man was referred to our department because a cystic mass was fortuitously found in the right lateral nasopharyngeal wall during transnasal esophagogastroscopy. He had suffered from intermittent right-sided nasal obstruction since childhood. T1- and T2-weighted magnetic resonance imaging revealed hyperintense signals. Marsupialization was performed by diode laser via an endoscopy-guided approach. No immediate postoperative complications occurred, and there was no recurrence 6 months following surgery. When a cystic lesion presents in the lateral nasopharynx, branchial cleft cyst should be considered in the differential diagnosis. In our experience, marsupialization by diode laser via an endoscopy approach is a safe and straightforward method of treating nasopharyngeal branchial cleft cyst, with no adverse effects.

Transnasal Endoscopic Surgery by Powered Instrumentation in the Treatment of Symptomatic Nasopharyngeal Cysts- Our Experience

“…3 Other approaches used are transmandibular and transcervical route for nasobranchial cysts. 4 Complications like haemorrhage, velopharyngeal insufficiency, cosmetic deformity and extreme scarring have been reported with these approaches. 4 The advent of endoscopes greatly improved visualization of the nasopharynx and the adjacent normal structures could be identified in a better way and protected.…”

“…4 Complications like haemorrhage, velopharyngeal insufficiency, cosmetic deformity and extreme scarring have been reported with these approaches. 4 The advent of endoscopes greatly improved visualization of the nasopharynx and the adjacent normal structures could be identified in a better way and protected. Use of cold steel instruments are described in literature for either excision or marsupialisation of the cysts.…”

Branchial cleft and pouch anomalies in childhood: a report of 50 surgical cases

“…These can occur anywhere along the embryologic tract between the neck anterior region to the sternocleidomastoid muscle and the tonsillar fossa, with the majority occurring in the upper third of the neck; usually they are located along the anterior border of the sternocleidomastoid muscle [11,13]. Second branchial cleft cysts were classified into four types by Proctor [14]: Type I: superficial cysts lying anterior to the sternocleidomastoid muscle and beneath the cervical fascia; Type II: cysts lying on the great vessels (the most common); Type III: lesions extending between the internal and external carotid arteries; Type IV: cysts lying adjacent to the pharyngeal wall and medial to the great vessels.…”

Unilateral Nasal Obstruction Caused by a Large Nasopharyngeal Cyst

“…Congenital cysts, such as Thornwaldt's cysts, are usually located in the midline; lateral nasopharyngeal cysts are usually acquired cysts [3]. The differential diagnosis of nasopharyngeal cysts includes Thornwaldt's cyst, intra-adenoid cyst, chordoma, cystic degeneration of a nasopharyngeal tumor, branchial cyst, dermoid cyst, seromucinous retention cyst, herniation of central nervous system, and sphenoid sinus mucocele [4]. Asymptomatic nasopharyngeal cysts are commonly and incidentally encountered during routine nasopharyngoscopy and radiologic imaging.…”

“…For larger or symptomatic cysts, complete surgical excision or marsupialization via an endonasal endoscopic approach should be the main treatment. Surgical intervention via transoral, transpalatal, transmandibular, and transcervical approaches carries more significant morbidity [4,5].…”