Nasopharyngeal pouch. Also known as nasopharyngeal cysts, they correspond mainly to congenital malformations . They generally present asymptomatically, being diagnosed during adolescence or adulthood, as a result of an imaging or endoscopic finding during the radiological study of the skull .
Not all require surgical management, in the vast majority a clinical-radiological follow-up of the lesions is sufficient . Bulky cysts, which determine obstructive involvement at the level of the airway, eustachian tube , pain , hemorrhage, or involvement of the cranial nerves, are subsidiary to surgical management.
Summary
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- 1 Etiology
- 2 Pathological anatomy
- 3 Symptoms
- 4 Treatment
- 5 Sources
Etiology
The nasopharyngeal pouch or sac appears to form from an embryonic pouch. The pharyngeal segment of the notochord is admitted to remain attached to the pharyngeal endoderm .
Pathological anatomy
The sac and its duct, extended to the pharyngeal mucosa, are located below the adenoid or its remains. The sac extends back and up to the periosteum of the occipital bone.
Symptoms
The symptoms that usually seen with postnasal drip, frequent colds, sneezing , hoarseness , fetid breath and coughing . Other symptoms may occur, such as headache or pain in various parts of the head and neck , especially in the back of the head, immediately below the occipital bone, nasal obstruction, sore throat, nasal voice, and cervical adenitis. There may be ear-related symptoms such as dizziness , ringing in the ears , ear pain, and deafness .
The duct can be explored using a throat mirror or Yankauer’s direct speculum . If there is an abscess, a small depression is observed on the surface of the swelling. A probe can be passed up into it.
Treatment
The blade of a curved pharyngeal scissors is inserted into the duct and half of the adenoid mass is sectioned. The opposite scissor blade is then inserted similarly for the other half and this portion is sectioned. The remaining parts of the adenoid tissue can be removed in the usual way. The remaining posterior portion of the duct or cyst wall should be carefully cured in order to remove any remaining membrane.
