Nasopharyngeal cyst refers to

cyst A cyst is a closed sac, having a distinct envelope and division compared with the nearby tissue. Hence, it is a cluster of cells that have grouped together to form a sac (like the manner in which water molecules group together to form a bubble) ...

ic swelling arising from midline and lateral wall of the

nasopharynx The pharynx (plural: pharynges) is the part of the throat behind the mouth and nasal cavity, and above the oesophagus and trachea (the tubes going down to the stomach and the lungs). It is found in vertebrates and invertebrates, though its struct ...

. The commonest cyst arising from lateral wall is the nasopharyngeal branchial cyst, whereas the

mucus Mucus ( ) is a slippery aqueous secretion produced by, and covering, mucous membranes. It is typically produced from cells found in mucous glands, although it may also originate from mixed glands, which contain both serous and mucous cells. It ...

retention cysts are the commonest to arise from the midline. Sometimes nasopharyngeal cyst may directly refer to

Tornwaldt cyst A Tornwaldt cyst also spelt as Thornwaldt or Thornwald cyst is a benign cyst located in the upper posterior nasopharynx The pharynx (plural: pharynges) is the part of the throat behind the mouth and nasal cavity, and above the oesophagus and tr ...

. It arises from the midline and lies deep to the pharyngobasilar fascia which helps to distinguish it from a mucous retention cyst. The main difference lies in that nasopharyngeal branchial cyst is congenital whereas the Tornwaldt's cyst is acquired.

Nasopharyngeal Branchial Cyst

These are congenital cysts often arising from the fossa of Rosenmüller located in the lateral wall of the nasopharynx. They represent remnants of first branchial cleft. These may extend superiorly to reach the bony confines of eustachian tube even to the skull base. Initially patients are asymptomatic but may present with aural fullness, unilateral conductive hearing loss, and serous otitis media as the cyst mass grows. In even more rare cases, they may be the source for unexplained sinonasal symptoms, such as CSF rhinorrhea, visual disturbances and nasal obstruction.

Diagnosis

In most of the cases incidental diagnosis happens while performing nasal endoscopy. MRI and CT scan can be helpful for further confirmation of diagnosis. On CT scan a low density, well capsulated mass in the roof of nasopharynx is suggestive of Thornwaldt cyst.

Differential Diagnosis

Differential diagnosis of this cyst are branchial cleft cyst, Rathke cleft cyst, neurenteric cyst,

nasopharyngeal carcinoma Nasopharyngeal carcinoma (NPC), or nasopharynx cancer, is the most common cancer originating in the nasopharynx, most commonly in the postero-lateral nasopharynx or pharyngeal recess ( fossa of Rosenmüller), accounting for 50% of cases. NPC occurs ...

, adenoid retention cyst,

meningocele Spina bifida (Latin for 'split spine'; SB) is a birth defect in which there is incomplete closing of the spine and the membranes around the spinal cord during early development in pregnancy. There are three main types: spina bifida occulta, men ...

and

meningomyelocele Spina bifida (Latin for 'split spine'; SB) is a birth defect in which there is incomplete closing of the spine and the membranes around the spinal cord during early development in pregnancy. There are three main types: spina bifida occulta, m ...

Treatment

Surgery is performed once symptomatic using transplatatine or endonasal route with the help of nasal endoscopy.

References

{{Reflist Cysts Pharynx