Sažetak sa skupa
Nasopharyngeal presentation of second branchial cleft cyst: diagnosis and surgical management - case report of 29-year-old female patient - poster presentation
Vladan Stanojković
; ENT depp. Hospital Izola, Polje 40 Slovenia
Sažetak
Branchial cleft fistulae are rare congenital abnormalities that arise from the abnormal persistence of
branchial apparatus remnants. A complete fistula is a tract that has an internal opening and an external opening.
Second branchial cleft fistulae pass deep to second arch structures and over third arch structures, in a direction
extending from the anterior border of the sternocleidomastoid (SCM) muscle to the upper pole of the ipsilateral
tonsil fossa. Because of this anatomical route, these long tubular structures are intimately associated with major
neuro-vascular structures in the neck. Fistulae are usually clinically apparent after birth with up to 80% being
diagnosed before the age of 5 years. There may be an obvious opening in the anterior neck between the hyoid
bone and suprasternal notch. Treatment is complete surgical excision and extirpation in toto of all abnormally
placed epithelium, while preserving surrounding neurovascular structures and using cosmetically acceptable
incisions. Complete fistulae in adults are rare and diagnosis can be difficult. Second branchial cleft cysts are
the most common neck masses found in adults. However, the parapharyngeal or pharyngeal presence of
branchial cleft cyst is very rare. It occurs as cervical sinus that temporarily appears in the process of branchial
apparatus developing into various structures of the neck, and is not closed but remains to exist. However, there
is a very rare case where second branchial cleft cyst appears in the form of cystic mass that is located in the
parapharyngeal or pharyngeal space. A rare location in the pharyngeal presence has been shown in only three
cases in the world. We report one case of nasopharyngeal branchial cleft cyst in adults. We present the clinical
presentation and surgical management of a sized cystic structure (40x25x9 mm), second branchial cleft cyst,
pharyngeal presentation located from the epipharyngeal space to the hyoid bone in a 29-year-old female patient
with main complaints of a swelling sensation of the pharynx, dysphagia and throat pain that had continued 2
days before otorhinolaringologist-examining.
Preoperative CT scans of the neck clearly demonstrated the cyst. Biopsy revealed a squamous lined
epithelial wall with lymphoid aggregation, which is characteristic of the branchial cleft cyst. We recommend
intra-oral surgery to allow safe and complete extirpation per via naturale. The author completely removed the
cyst in intraoral approach for cystic mass in the pharyngeal space. We performed a transoral resection without
any surgical complications - one day surgery. The excision of the cyst was performed in incision (extirpatio)
of left oropharyngeal membrane under general anesthesia.
Ključne riječi
branchial region; cysts; oropharynx; congenital neck masses
Hrčak ID:
272973
URI
Datum izdavanja:
27.2.2022.
Posjeta: 326 *