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Nasopharyngeal Branchial Cyst, a Rare Presentation

Received: 14 March 2016     Accepted: 16 March 2016     Published: 18 April 2016
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Abstract

Introduction: Branchial cleft cysts are congenital developmental defects of which second branchial anomalies are the most common type. Most of these anomalies present as a lateral neck mass along anterior border of sternocliedomastoid muscle. Careful examination and proper intervention is needed in some of these cases to avoid unwanted complications or even emergencies. Case presentation: A 5 years old boy was brought by his parents with history of dysphagia and snoring for about one month. There was no other associated history of sore throat or shortness of breath or oral bleeding. During fiberoptic examination we found a pedunculated left nasopharyngeal mass. CT imaging showed a left nasopharyngeal hypodense lesion with no vascular or bony invasion. Excision of the cyst was done via combined transoral/transnasal endoscopic approach. Follow up after eight months showed no evidence of recurrence. Conclusion: Second branchial cleft cysts presenting in the nasopharynx are considered rare presentations of the disease and other differential diagnosis should be always brought in mind. Fiberoptic examination of such cases is mandatory to rule out laryngeal involvement and to predict the extension of the cyst for surgical intervention. Surgical excision through combined transoral/transnasal endoscopic including the tract ligation is the treatment of choice to prevent recurrence and to minimize the occurrence of possible secondary infection of the cyst.

Published in Journal of Surgery (Volume 4, Issue 3-1)

This article belongs to the Special Issue Surgical Infections and Sepsis

DOI 10.11648/j.js.s.2016040301.15
Page(s) 25-28
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2016. Published by Science Publishing Group

Keywords

Branchial Cleft, Nasopharyngeal Cyst, Pediatric, Transoral Excision

References
[1] Koeller KK, Alamo L, Adair CF, et al., Congenital cystic masses of the neck: radiologicpathologic correlation. Radiographics. 1999 Jan-Feb; 19(1): 121-46.
[2] Kenealy JF, Torsiglieri AJ, Tom LW. Branchial cleft anomolies: a five-year retrospective review. Trans Penn Acad Ophthalmol Otolaryngol 1990; 42: 1022-1025.
[3] Papay FA, Kalucis C, Eliachar I, Tucker HM. Nasopharyngeal presentation of second branchial cleft cyst. Otolaryngol Head Neck Surg. 1994 Feb; 110(2): 232-4.
[4] Ostfeld EJ, Wiesel JM, Rabinson S, Auslander L. Parapharyngeal (retrostyloid)--third branchial cleft cyst. J Laryngol Otol. 1991 Sep; 105(9): 790-2.
[5] Grignon B, Pierucci F, Wayoff M, Roland J. Branchial cyst of unusual localization: report of a case and considerations on organogenesis. Morphologie. 1997 Sep; 81(254): 9-11.
[6] Chandler JR, Mitchell B. Branchial cleft cysts, sinuses and fistulas. Otolaryngol Clin North Am 1981; 13: 175.
[7] Wagner AM, Hansen RC. Neonatal skin and skin disorders. In: Schachner LA, Hansen RC, eds. Pediatric Dermatology. Vol 1. 2nd ed. New York, NY: Churchill Livingston; 1995: 291-3.
[8] Doi O, Hutson JM, Myers NA, McKelvie PA. Branchial remnants: a review of 58 cases. J Pediatr Surg. Sep 1988; 23(9): 789-92.
[9] Little JW, Rickles NH. The histogenesis of the branchial cyst. Am J Pathol. 1967; 50(3): 533-47.
[10] Rickles NH, Little JW. The histogenesis of the branchial cyst. II. A study of the lining epithelium. Am J Pathol. 1967; 50(5): 765-77.
[11] Telander RL, Deane SA. Thyroglossal and branchial cleft cysts and sinuses. SurgClin North Am. Aug 1977; 57(4): 779-91.
[12] Choi SS, Zalzal GH. Branchial anomolies: a review of 52 cases. Laryngoscope. 1995 Sep; 105(9 Pt 1): 909-13.
[13] Work WP. Cysts and congenital lesions of the parotid glands. Otolaryngol Clin North Am. 1977 Jun; 10(2): 339-43.
[14] Sandborn WD, Shafer AD. A branchial cleft of fourth pouch origin. J Pediatr Surg 1972 Feb; 7(1): 82.
[15] Joshi MJ, Provenzano MJ, Smith RJ, Sato Y, Smoker WR. The rare third branchial cleft cyst. AJNR Am J Neuroradiol. 2009 Oct; 30(9): 1804-6.
[16] Koch BL. Cystic malformations of the neck in children. Pediatr Radiol 2005; 35: 463–77.
[17] Panchbhai AS, Choudhary MS. Branchial cleft cyst at an unusual location: a rare case with a brief review. Dentomaxillofac Radiol. 2012 Dec; 41(8): 696-702.
[18] Jeyakumar A, Hengerer AS. Various presentations of fourth branchial anomolies. Ear Nose Throat J. 2004 Sep; 83(9): 640-2,644.
[19] Kotecha V, Muturi A, Ruturi J. Branchial cysts: an unusual cause of a mediastinal mass: a case report. J Med Case Rep. 2015 Sep 29; 9: 208. doi: 10.1186/s13256-015-0680-y.
[20] Fageeh NA, Etwadi H, Alqarni M, Alsharif S. Nasopharyngeal branchial cleft cyst. National Journal of Otorhinolaryngology and Head & Neck Surgery, 2015, 3(12): 30-31.
Cite This Article
  • APA Style

    Wael Al Juraibi. (2016). Nasopharyngeal Branchial Cyst, a Rare Presentation. Journal of Surgery, 4(3-1), 25-28. https://doi.org/10.11648/j.js.s.2016040301.15

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    ACS Style

    Wael Al Juraibi. Nasopharyngeal Branchial Cyst, a Rare Presentation. J. Surg. 2016, 4(3-1), 25-28. doi: 10.11648/j.js.s.2016040301.15

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    AMA Style

    Wael Al Juraibi. Nasopharyngeal Branchial Cyst, a Rare Presentation. J Surg. 2016;4(3-1):25-28. doi: 10.11648/j.js.s.2016040301.15

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  • @article{10.11648/j.js.s.2016040301.15,
      author = {Wael Al Juraibi},
      title = {Nasopharyngeal Branchial Cyst, a Rare Presentation},
      journal = {Journal of Surgery},
      volume = {4},
      number = {3-1},
      pages = {25-28},
      doi = {10.11648/j.js.s.2016040301.15},
      url = {https://doi.org/10.11648/j.js.s.2016040301.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.s.2016040301.15},
      abstract = {Introduction: Branchial cleft cysts are congenital developmental defects of which second branchial anomalies are the most common type. Most of these anomalies present as a lateral neck mass along anterior border of sternocliedomastoid muscle. Careful examination and proper intervention is needed in some of these cases to avoid unwanted complications or even emergencies. Case presentation: A 5 years old boy was brought by his parents with history of dysphagia and snoring for about one month. There was no other associated history of sore throat or shortness of breath or oral bleeding. During fiberoptic examination we found a pedunculated left nasopharyngeal mass. CT imaging showed a left nasopharyngeal hypodense lesion with no vascular or bony invasion. Excision of the cyst was done via combined transoral/transnasal endoscopic approach. Follow up after eight months showed no evidence of recurrence. Conclusion: Second branchial cleft cysts presenting in the nasopharynx are considered rare presentations of the disease and other differential diagnosis should be always brought in mind. Fiberoptic examination of such cases is mandatory to rule out laryngeal involvement and to predict the extension of the cyst for surgical intervention. Surgical excision through combined transoral/transnasal endoscopic including the tract ligation is the treatment of choice to prevent recurrence and to minimize the occurrence of possible secondary infection of the cyst.},
     year = {2016}
    }
    

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  • TY  - JOUR
    T1  - Nasopharyngeal Branchial Cyst, a Rare Presentation
    AU  - Wael Al Juraibi
    Y1  - 2016/04/18
    PY  - 2016
    N1  - https://doi.org/10.11648/j.js.s.2016040301.15
    DO  - 10.11648/j.js.s.2016040301.15
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 25
    EP  - 28
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.s.2016040301.15
    AB  - Introduction: Branchial cleft cysts are congenital developmental defects of which second branchial anomalies are the most common type. Most of these anomalies present as a lateral neck mass along anterior border of sternocliedomastoid muscle. Careful examination and proper intervention is needed in some of these cases to avoid unwanted complications or even emergencies. Case presentation: A 5 years old boy was brought by his parents with history of dysphagia and snoring for about one month. There was no other associated history of sore throat or shortness of breath or oral bleeding. During fiberoptic examination we found a pedunculated left nasopharyngeal mass. CT imaging showed a left nasopharyngeal hypodense lesion with no vascular or bony invasion. Excision of the cyst was done via combined transoral/transnasal endoscopic approach. Follow up after eight months showed no evidence of recurrence. Conclusion: Second branchial cleft cysts presenting in the nasopharynx are considered rare presentations of the disease and other differential diagnosis should be always brought in mind. Fiberoptic examination of such cases is mandatory to rule out laryngeal involvement and to predict the extension of the cyst for surgical intervention. Surgical excision through combined transoral/transnasal endoscopic including the tract ligation is the treatment of choice to prevent recurrence and to minimize the occurrence of possible secondary infection of the cyst.
    VL  - 4
    IS  - 3-1
    ER  - 

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Author Information
  • Department of Otolaryngology & Head and Neck Surgery, Al Hayat National Hospital, Jazan, Saudi Arabia

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