[Pharyngeal cysts of branchial origin, a review of the literature and a clinical case report].
Nasal pharyngeal swellings are very often treated without a previous complete clinical examination of the patient and of the disease site. For this reason the recurrence rate of this pathology is quite high. The causes for this phenomenon are likely due to the benign aspect of the tumor and the easy approach to the pharynx. Leaving aside the therapeutical aspect, there are also multiple theories concerning the etiology of pharyngeal cyst based on epidemiological and histopathological observations. Branchiogenic origin very likely seems to be the cause of cystic swelling arising at the lateral side of the pharynx, between the Eustachian tube and the posterior tonsillar pillar. Examination of the case review collected from literature, revealed that diagnostic and therapeutical procedures performed by various authors seem to be very haphazard, ranging from simple physical examination and puncture draining to CT and/or MRI scanning and external trans-mandibular approach to the cyst. The authors describe one case of a subject with a pharyngeal branchial cyst, who had been previously undergone puncture drainage. The correct diagnosis was achieved through MRI and cytologic examination of the fluid aspirated from the cyst. With MRI it was possible to make a correct topo-diagnosis, which localized the position of the cyst in the left pharyngo-tonsillar recesses, medial to the pharyngeal constrictor muscles. MRI also confirmed the absence of fistulous ducts connected to the cyst. These clinical and laboratory data induced us to use an intra-oral approach to the cyst, which was removed by blunt dissection. Physical examination and MRI were repeated six months later and showed the complete removal of the cyst and the presence of a synechia between the upper part of the left posterior pillar and the pharyngeal wall. No further treatment was given because of the absence of symptoms. The authors stress the importance of less invasive surgery in the case of pharyngeal cyst possible after detailed monitoring of the disease site with modern computed tomography CT, MRI.
Ruscito
P
P
II Clinica ORL, Università di Perugia, Sede di Terni.
Longari
F
F
Bicciolo
G
G
Rizzo
S
S
Ottaviano
P
P
Frenguelli
A
A
D000328:Adult; D001935:Branchioma / Q000150:complications* / Q000473:pathology; D003560:Cysts / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D010610:Pharyngeal Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D010614:Pharynx / Q000473:pathology / Q000601:surgery
Cisti faringee di origine branchiale, revisione della letteratura e presentazione di un caso clinico.