Nasopharyngeal cysts in children

Abstract

Background. Nasopharyngeal cysts are mostly congenital malformations. However, their clinical manifestation can also occur in adolescence, depending on their severity, size and location. Nasopharyngeal cysts are rare in the practice of an otolaryngologist, but can be found in nasal obstruction. The article presents the literature data on the theories of the origin, clinical manifestations, peculiarities of the diagnostics and surgical treatment of the nasopharyngeal cysts. Aim. To increase the efficiency of diagnostics and treatment of nasopharyngeal cysts in children on the basis of a differentiated approach to the manifestation of the disease symptoms. Materials and methods. 29 patients aged from 1 to 8 years (mean age 4.210.39 years) with nasopharyngeal cysts and cyst-like neoplasms were treated at the clinical sites of the Department of Otorhinolaryngology and Pediatric Department of Pirogov Russian National Research Medical University (Moscow) from 2009 to 2022. Results. On admission all 29 (100%) children complained of an increasing nasal obstruction, anterior and posterior purulent rhinorrhea, snoring, decreased hearing, and epiphora. 18 patients (62.1%) had a history of recurrent otitis media and were diagnosed with bilateral exudative otitis media on examination. Transnasal or transoroepipharyngeal endoscopic marsupialization and cyst coagulation with an electrosurgical complex were performed in 28 (96.5%) children. In 19 (65.5%) cases the operation was performed with a single-stage adenotomy and in 8 (27.6%) cases with tubal valvular plasty, partial destruction of the tubal tonsils. Conclusion. Improvement of diagnostics quality due to modern imaging technologies leads to detection of a greater number of accidental findings of nasopharyngeal cysts and requires systematization and detailed elaboration of the accumulated knowledge in the work of the pediatric otorhinolaryngologist.