Nasopharyngeal cysts in children

Cover Page

Cite item


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 – 4.21±0.39 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.

Full Text

Restricted Access

About the authors

Elena N. Kotova

Pirogov Russian National Research Medical University; Federal Research and Clinical Center of Physical-Chemical Medicine

ORCID iD: 0000-0002-0318-7179

Cand. Sci. (Med.), Pirogov Russian National Research Medical University, Federal Research and Clinical Center of Physical-Chemical Medicine

Russian Federation, Moscow; Moscow

Eduard O. Vyazmenov

Pirogov Russian National Research Medical University; Federal Research and Clinical Center of Physical-Chemical Medicine

ORCID iD: 0000-0002-2880-4882

Cand. Sci. (Med.), Pirogov Russian National Research Medical University, Federal Research and Clinical Center of Physical-Chemical Medicine

Russian Federation, Moscow; Moscow

Konstantin K. Baranov

Pirogov Russian National Research Medical University; Federal Research and Clinical Center of Physical-Chemical Medicine

Author for correspondence.
ORCID iD: 0000-0001-8268-815X

Cand. Sci. (Med.), Pirogov Russian National Research Medical University, Federal Research and Clinical Center of Physical-Chemical Medicine

Russian Federation, Moscow; Moscow


  1. Пальчун В.Т. Оториноларингология: национальное руководство. Краткое изд. Под ред. В.Т. Пальчуна. М.: ГЭОТАР-Медиа, 2008 [Pal'chun VT. Otorinolaringologiia: natsional'noe rukovodstvo. Pod red. VT Pal'chuna. Moscow: GEOTAR-Media, 2008 (in Russian)].
  2. Крюков А.И., Царапкин Г.Ю., Колбанова И.Г., Шурпо В.И. Носогубная киста в практике оториноларинголога. Вестник отоларингологии. 2016;81(5):77-80 [Kryukov AI, Tsarapkin GYu, Kolbanova IG, Shurpo VI. The nasolabial cyst encountered in the practical work of the otorhinolaryngologists. Vestnik otorinolaringologii. 2016;81(5):77-80 (in Russian)]. doi: 10.17116/otorino201681577-80
  3. Miyahara H, Matsunaga T. Tornwaldt's disease. Acta Otolaryngol Suppl. 1994;517:36-9. doi: 10.3109/00016489409124336
  4. Marom T, Russo E, Ben Salem D, Roth Y. Nasopharyngeal Cysts. Int J Pediatr Otorhinolaryngol. 2009;73(8):1063-70. doi: 10.1016/j.ijporl.2009.01.004
  5. Авербух В.М. Сумка Торнвальдта: клинические проявления, методы визуализации и результаты хирургического лечения. Российская ринология. 2010;18(2):24-30 [Averbukh VM. Tornwaldt''s cyst: oral and pharyngeal disorders, diagnostic and treatment. Rossiskaya rinologiya. 2010;18(2):24-30 (in Russian)].
  6. Chang S-L, Wu T-C, Yiu C-Y. Tornwaldt's cyst formation after concurrent chemoradiotherapy for nasopharyngeal carcinoma. J Laryngol Otol. 2006;120(11):959-60. doi: 10.1017/s0022215106001241
  7. Moody MW, Chi DH, Mason JC, et al. Tornwaldt's cyst: incidence and a case report. Ear Nose Throat J. 2007;86(1):45-7.
  8. Kwok P, Hawke M, Jahn A, Mehta M. Tornwaldt's cyst: clinical and radiological aspects. J Otolaryngol. 1987;16(2):104-7.
  9. Miller R, Sneed W. Tornwaldt's bursa. Clin Otolaryngol Allied Sci. 1985;10(1):21-5. doi: 10.1111/j.1365-2273.1985.tb01160.x
  10. Chong V, Fan Y. Radiology of the nasopharynx: pictorial essay. Australas Radiol. 2000;44(1):5-13. doi: 10.1046/j.1440-1673.2000.00765.x
  11. Ikushima I, Korogi Y, Makita O, et al. MR imaging of Tornwaldt's cysts. Am J Roentgenol. 1999;172(6):1663-5. doi: 10.2214/ajr.172.6.10350312
  12. Sato K, Oka H, Utsuki S, et al. Ciliated craniopharyngioma may arise from Rathke cleft cyst. Clin Neuropathol. 2006;25(1):25-8.
  13. Царапкин Г.Ю., Товмасян А.С., Арзамазов С.Г., Кишиневский А.Е. Дифференциальная диагностика и тактика лечения кистозных образований носоглотки. Вестник оториноларингологии. 2017;82(4):52-5 [Tsarapkin GYu, Tovmasyan AS, Arzamazov SG, Kishinevskii AE. Differential diagnostics and the strategy for the management of the nasopharyngeal cystic lesions. Vestnik otorinolaringologii. 2017;82(4):52-5 (in Russian)].
  14. Карпищенко С., Скиданова И., Верещагина О. Диагностика и хирургическое лечение кист носоглотки. Врач. 2013;2:58-63 [Karpishchenko S, Skidapnova I, Vereshchagina O. The diagnosis and surgical treatment of nasopharyngeal cysts. Vrach. 2013;2:58-63 (in Russian)].
  15. Ben Hamouda K, Khaldi M, Jemel H, et al. Rathke cleft cyst of the sphenoid and nasopharynx. Case illustration. J Neurosurg. 2005;103(6):1095. doi: 10.3171/jns.2005.103.6.1095
  16. Ben Salem D, Duvillard C, Assous D, et al. Imaging of nasopharyngeal cysts and bursae. Eur Radiol. 2006;16(10):2249-58. doi: 10.1007/s00330-006-0238-x
  17. Papay FA, Kalucis C, Eliachar I, Tucker HM. Nasopharyngeal presentation of second branchial cleft cyst. Otolaryngol Haed Neck Surg. 1994;110(2):232-4. doi: 10.1177/019459989411000214
  18. Flis D, Wein R. Nasopharyngeal Branchial Cysts – Diagnosis and Management: A Case Series. J Neurol Surg B Skull Base. 2013;74(1):50-3. doi: 10.1055/s-0032-1331020
  19. Shefelbine SE, Mancuso AA, Gajewski BJ, et al. Pediatric retropharyngeal lymphadenitis: differentiation from retropharyngeal abscess and treatment implications. Otolaryngol Head Neck Surg. 2007;136(2):182-8. doi: 10.1016/j.otohns.2006.03.002
  20. Weiner GM, Pahor AL. Tuberculous nasopharyngeal cyst: diagnostic aspiration using the nasendoscope. J Laryngol Otol. 1994;108(6):505-6. doi: 10.1017/s0022215100127240
  21. Spencer L, Ukwu M, Alexander T, et al. Epidemiology of Pneumocystis colonization in families. Clin Infect Dis. 2008;46(8):1237-40. doi: 10.1086/533449
  22. Ali MY. Pathogenesis of cysts and crypts in the nasopharynx. J Laryngol Otol. 1965;79:391-402. doi: 10.1017/s0022215100063854
  23. Hossein A, Mohammad A. Huge teratoma of the nasopharynx. Am J Otolaryngol. 2007;28(3):177-9. doi: 10.1016/j.amjoto.2005.05.006
  24. Shaw AS, Conor SEJ. Parasellar epidermoid cyst rupturing into the nasopharynx. J Laryngol Otol. 2005;119(2):140-3. doi: 10.1258/0022215053419934
  25. Smirniotopoulos JG, Chiechi MV. Teratomas, dermoids, and epidermoids of the head and neck. Radiographics. 1995;15(6):1437-55. doi: 10.1148/radiographics.15.6.8577967
  26. Mahapatra AK, Agrawal D. Anterior encephaloceles: a series 103 cases over 32 years. J Clin Neurosci. 2006;13(5):536-9. doi: 10.1016/j.jocn.2005.05.016
  27. Götz W, Kasper M, Miosge N, Hughes RC. Detection and distribution of the carbohydrate binding protein galectin-3 in human notochord, intervertebral disc and chordoma. Differentiation. 1997;62(3):149-57. doi: 10.1046/j.1432-0436.1997.6230149.x
  28. Taguchi Y, Tanaka K, Miyakita Y, et al. Recurrent craniopharyngioma with nasopharyngeal extension. Pediatr Neurosurg. 2000;32(3):140-4. doi: 10.1159/000028919
  29. Mohanty S, Balakrishnan S. Management of extra-sellar craniopharyngioma masquerading as hypertrophied adenoid tissue in a 6-year-old boy. Int J Pediatr Otolaryngol. 2008;72(9):1441-4. doi: 10.1016/j.ijporl.2008.05.022

Supplementary files

Supplementary Files
1. Fig. 1. Cyst of the nasopharynx. Endoscopic picture.

Download (98KB)
2. Fig. 2. Median cyst of the nasopharynx according to computed tomography in the coronal projection.

Download (83KB)
3. Fig. 3. Dermoid cyst of the nasopharynx: a – CT data in the axial projection; b –appearance.

Download (203KB)

Copyright (c) 2022 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 74329 от 19.11.2018 г.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies