Surgical technique of transoral marsupialization for the treatment of nasopharyngeal branchial cysts.
OBJECTIVE
Nasopharyngeal branchial cysts (NBCs) are derived from a remnant of the branchial apparatus and originate from the lateral wall of the nasopharynx. Total excision of these cysts was the standard treatment in the past. We present a simpler and less invasive approach for NBC treatment, involving marsupialization, and report on its effectiveness and advantages.


METHODS
The surgical approach was transoral. A circular incision 2 to 3 cm in diameter was made directly through the inferior wall of the cyst. After the NBC was drained, its opening was widened with scissors. A disk of oropharyngeal mucosa and the connecting inferior wall of the cyst were excised together. The cut edges of the inner lining of the cyst and the oropharyngeal mucosa were approximated with sutures.


RESULTS
All 4 patients were female. One patient was observed because of poor cardiovascular health. The 3 patients who were managed surgically underwent successful transoral cyst marsupialization. The mean follow-up period was 21 months (range, 8 to 40 months). No obvious postoperative complication or recurrence was noted.


CONCLUSIONS
Transoral marsupialization is a simple, effective, and less invasive method for treatment of NBCs.
Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung Hsien, Taiwan.
Tsung-Yen
TY
Tsai
Chih-Ying
CY
Su
D000328:Adult; D000368:Aged; D001935:Branchioma / Q000175:diagnosis / Q000601:surgery*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009305:Nasopharynx / Q000002:abnormalities*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods