ABSTRACT
Tornwaldt's cyst is a benign developmental lesion of the nasopharynx, most of all midline located, originating from an outpouching of the pharyngeal mucosa caused by notocord retraction. Usually, the cyst represents an incidental finding of magnetic resonance study. The purpose of this study is to investigate the differential diagnostic aspects of Tornwaldt's cysts, making a comparison with other diseases of nasopharynx on the basis of morphological characteristics and signal, contributing to the previous statistical works.
Subject(s)
Cysts/pathology , Magnetic Resonance Imaging/methods , Nasopharyngeal Diseases/pathology , Nasopharynx/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Cysts/embryology , Female , Humans , Incidental Findings , Male , Middle Aged , Nasopharyngeal Diseases/embryology , Nasopharynx/embryology , Notochord/pathology , Retrospective Studies , Young AdultABSTRACT
Tornwaldt's disease was first described by Tornwaldt as one of the causes of epipharyngitis, and is an inflammation or abscess of the embryonic remnant cyst of the pharyngeal bursa appearing at the posterior median wall of the nasopharynx. Although many cases are symptom-free, symptoms can often be caused by nasal tamponade, trauma, adenotomy, or other mechanical stimuli. Only a few cases have been reported in Japan between 1929 and 1992. At about the 10th week of embryonic development, the pouch, which forms by adhesion of the pharyngeal ectoderm to the notochord at the most cranial end of the notochord, becomes closed at the orifice (cystic type), or crusts adhere to the orifice without closing (crust type). Symptoms are those of upper respiratory tract infection with obstinate occipital pain, purulent choanal discharge, nasal obstruction, halitosis, feeling of ear fullness, clearing of the throat, etc. Posterior rhinoscopy, simple lateral view X-ray tomography, nasopharyngeal fiberoscopy, CT scan and MRI are useful in showing adhesion to the cervical vertebrae. While complete extirpation via a transpalatal approach is desirable, incision or excision of the cyst can also be performed.
Subject(s)
Cysts , Nasopharyngeal Diseases , Cysts/diagnosis , Cysts/embryology , Cysts/surgery , Humans , Nasopharyngeal Diseases/diagnosis , Nasopharyngeal Diseases/embryology , Nasopharyngeal Diseases/surgeryABSTRACT
Tornwaldt's bursae or nasopharyngeal bursae originate at the interface between the embryonic tissue from which the vertebrae develop (the notochord), and the developing foregut. If the opening through which the bursa drains into the nasopharynx becomes obstructed, a Tornwaldt's cyst will develop. The history, clinical and radiological findings and the operative management of a patient with an infected Tornwaldt's cyst are presented.
Subject(s)
Cysts/diagnosis , Nasopharyngeal Diseases/diagnosis , Adult , Cysts/embryology , Cysts/surgery , Humans , Male , Nasopharyngeal Diseases/embryology , Nasopharyngeal Diseases/surgery , Notochord , Tomography, X-Ray ComputedABSTRACT
Seven cases of calcification in the roof of the nasopharynx are reported. These calcifications situated in the midline opposite the pharyngeal bursa, were associated in four patients with a neural or osseous defect of the craniocervical junction. The authors estimate the frequency of this asymptomatic calcification to be about 0.1%. This finding is thought to be a calcified remnant of the notochord.
