1
|
Raghavan M, Carr MM. Age-related outcomes after pediatric branchial cleft cyst excision via NSQIP-P. Int J Pediatr Otorhinolaryngol 2024; 176:111811. [PMID: 38048733 DOI: 10.1016/j.ijporl.2023.111811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/21/2023] [Accepted: 11/26/2023] [Indexed: 12/06/2023]
Abstract
OBJECTIVE Branchial cleft cysts present at varying ages; sometimes excision is delayed because of concern about operating in small children. Our goal was to determine if outcomes and complications differed among pediatric age groups. STUDY DESIGN Retrospective, cross-sectional. SETTING American College of Surgeons' National Surgical Quality Improvement Pediatric database. METHODS Patients who underwent a branchial cleft cyst excision between 2016 and 2020 were identified in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Pediatric database. Patients with CPT code 42,815: 'excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into the pharynx' as their primary procedure were included. Variables of interest included patient demographics, comorbidities, pre-operative risk factors and complications. RESULTS 2267 patients with median age of 3.9 (IQR: 7.4, range: 0.04-17.9) years were included. The most common pre-operative risk factors were 149 (7 %) patients with prematurity, 136 (6 %) with developmental delay, 135 (6 %) with congenital malformation, and 128 (6 %) with open wound or wound infection. 68 (3 %) patients experienced at least one post-operative complication, with 73 post-operative complications documented in total. Surgical site infections were the most common complications with 49 (67.1 %) superficial infections, 11 (15.1 %) deep infections, and 4 (5.5 %) organ/space infections. Surgical site infections were the most common reason for related readmission. Duration of anesthesia and operative time increased significantly as patient age increased (p < .001 for both). There was no significant correlation between age and complication incidence. CONCLUSION Branchial cleft cyst excision is a relatively safe operation with a low complication rate, even in young pediatric populations.
Collapse
Affiliation(s)
- Maya Raghavan
- Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14209, USA
| | - Michele M Carr
- Department of Otolaryngology-Head and Neck Surgery, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14209, USA.
| |
Collapse
|
2
|
Alzaidi S, Alsulami OA, Alqarni S, Alqurashi A, Ghafouri A, Bin Abbas ES. Nasopharyngeal Branchial Cleft Cyst: A Rare Case Report and Literature Review. Cureus 2023; 15:e43432. [PMID: 37706148 PMCID: PMC10497237 DOI: 10.7759/cureus.43432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2023] [Indexed: 09/15/2023] Open
Abstract
Branchial cleft cysts are birth defects that happen when the first through fourth pharyngeal clefts do not close properly and most of these cysts develop from the second cleft. Second branchial cleft cysts are almost always in the neck, so it is rare for them to present in the nasopharynx. We report an extremely rare case of a branchial cleft cyst that is located in an unusual site in the nasopharynx in a 36-year-old male with no prior medical history. Computed tomography scan findings showed non-enhancing thickening of the right side mucosal-pharyngeal space, obliterating the fossa of Rosenmuller with no invasion or erosion. The patient was admitted for nasopharyngeal mass excision, and the mass was sent for histopathology. When a cystic lesion is noted in the lateral nasopharynx, branchial cleft cysts should be on the list of possible diagnoses. Surgery is primarily the treatment. The marsupialization approach is a simple way to treat nasopharyngeal branchial cleft cysts as it is safe and has limited complications.
Collapse
Affiliation(s)
- Suzan Alzaidi
- Otolaryngology - Head and Neck Surgery, King Fahad Armed Forces Hospital, Jeddah, SAU
| | - Omar A Alsulami
- Otolaryngology - Head and Neck Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Saad Alqarni
- Otolaryngology - Head and Neck Surgery, King Fahad Armed Forces Hospital, Jeddah, SAU
| | - Alshema Alqurashi
- Otolaryngology - Head and Neck Surgery, King Fahad Armed Forces Hospital, Jeddah, SAU
| | - Abdullah Ghafouri
- Otolaryngology - Head and Neck Surgery, King Fahad Armed Forces Hospital, Jeddah, SAU
| | - Elham S Bin Abbas
- Pathology and Medical Laboratory, King Fahad Armed Forces Hospital, Jeddah, SAU
| |
Collapse
|
3
|
Centello R, Sesti F, Feola T, Sada V, Pandozzi C, Di Serafino M, Pacini P, Cantisani V, Giannetta E, Tarsitano MG. The Dark Side of Ultrasound Imaging in Parathyroid Disease. J Clin Med 2023; 12:jcm12072487. [PMID: 37048571 PMCID: PMC10095081 DOI: 10.3390/jcm12072487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/14/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
The diagnosis of parathyroid diseases by imaging still has some intrinsic technical limitations due to the differential diagnosis of different structures of the neck that mimic the parathyroid glands. In this view, ultrasound (US) is an established, low-cost, and non-invasive imaging technique that still represents the first-line approach for evaluating patients with parathyroid disease. The objective of this article is to provide a comprehensive review of the applications of USs in clinical practice, discussing the histopathological and US characteristics of the parathyroid glands in normal and pathological conditions, the advantages of preoperative imaging, and novel updates on the most useful and currently available multiparameter US techniques.
Collapse
|
4
|
Muacevic A, Adler JR. Complications and Diagnosis of Branchial Cleft Cysts: A Case Report. Cureus 2022; 14:e32667. [PMID: 36660529 PMCID: PMC9845494 DOI: 10.7759/cureus.32667] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2022] [Indexed: 12/23/2022] Open
Abstract
Branchial cleft cysts (BCCs) are congenital anomalies that can be found in children and young adults. The exact incidence of these anomalies is unknown as the diagnosis may be missed. Branchial cleft cysts can present in a variety of locations depending on the cleft they are derived from. Regardless of location, branchial cleft cysts are rather benign. However, a variety of complications can arise due to infection, and infections are often recurrent. Diagnosis may occur incidentally on imaging studies as such studies are often performed to rule out a variety of complications from infections alone. Treatment includes first treating any infection and any such complications that exist, followed by surgical excision. Surgical excision is performed to prevent the recurrence of infection. A case of a 14-year-old female with a painful swollen throat, trismus, and difficulty swallowing is reported.
Collapse
|
5
|
Point-of-Care Ultrasound of the Head and Neck in Children. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-022-00419-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
6
|
Vazquez Salas S, Pedro K, Balram A, Syed S, Kotaka K, Kadivar A, Eke BO, McFarland M, Sung M, Behera N, Dubner BG, Maleki Z. Head and Neck Cystic Lesions: A Cytology Review of Common and Uncommon Entities. Acta Cytol 2022; 66:359-370. [PMID: 35717936 DOI: 10.1159/000525144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/05/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Cystic lesions of the head and neck are a diagnostic challenge since they are seen in the clinical presentation of a wide variety of conditions. Herein, common and uncommon entities that present as cystic lesions in the head and neck are reviewed. SUMMARY In this study, peer-reviewed articles were selected using the database PubMed, Google, Google Scholar, and Scopus. Emphasis was placed on peer-reviewed articles that discuss the cytomorphology and differential diagnosis of entities that present as cystic lesions of the head and neck. In the anterior neck, both benign and malignant neoplasms can present, including papillary thyroid carcinoma (PTC), thyroid adenomatoid nodule, parathyroid cysts, and thyroglossal cysts. In the lateral neck, branchial cleft cyst, PTC, ectopic thyroid cyst, and squamous cell carcinomas (human papilloma virus and non- human papilloma virus-related) are common. Age over 40 years raises the possibility of malignancy. In the deep neck, mostly benign cystic entities occur such as a pleomorphic adenoma, paraganglioma, schwannoma, branchial cyst, epidermal inclusion cyst, and lymphoepithelial cyst. Lesions with squamous cell features can pose diagnostic dilemmas. CONCLUSION Cytologic examination of head and neck cysts can provide valuable information regarding the nature of the cystic lesions. Information about anatomic site and clinical history can assist with the differential diagnoses. Ancillary studies can improve the diagnosis in some cases. Each case should be evaluated very carefully since there are a wide variety of congenital conditions, infectious/inflammatory conditions, benign neoplasms, and primary and secondary malignancies presenting as a cystic mass in the head and neck.
Collapse
Affiliation(s)
- Sandra Vazquez Salas
- Department of Pathology, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Katie Pedro
- Department of Pathology, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Amrita Balram
- Department of Pathology, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Sarah Syed
- Department of Pathology, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Kent Kotaka
- Department of Pathology, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Ana Kadivar
- Department of Public Health, University of Maryland, College Park, Maryland, USA
| | - Benjamin O Eke
- Department of Pathology, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Madison McFarland
- Department of Pathology, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Michelle Sung
- Department of Pathology, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Niranjan Behera
- Department of Pathology, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Benjamin G Dubner
- Department of Pathology, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Zahra Maleki
- Department of Pathology, The Johns Hopkins University School of Medicine and The Johns Hopkins Hospital, Baltimore, Maryland, USA
| |
Collapse
|
7
|
Brad Hall A, Hasara S, Coker P. Identification of a branchial cleft anomaly via handheld point-of-care ultrasound. J Ultrason 2022; 22:e67-e69. [PMID: 35449698 PMCID: PMC9009347 DOI: 10.15557/jou.2022.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/10/2021] [Indexed: 11/22/2022] Open
Abstract
Aim of the study Branchial anomalies result from incomplete obliteration of the branchial arch structures during embryogenesis. Second branchial arch anomalies are commonly found on the lower third of the neck, with an opening at the anterior border of the sternocleidomastoid muscle, and may drain secretions or purulent material. This case demonstrates the use of handheld point-of-care ultrasound to aid in the diagnosis of a branchial anomaly. Case description The patient presented with a “hole” in the neck with intermittent drainage from the site. A 2 mm defect in the skin was noted anterior to the sternocleidomastoid muscle. A handheld ultrasound system was used to identify a well-defined, hypoechoic, cyst-like structure. Given the history, physical findings, and point-of-care ultrasound imaging, the diagnosis of a second branchial cleft sinus was made. Conclusions The use of point-of-care ultrasound and knowledge of the sonographic characteristics of these lesions can assist the physician in the diagnosis of branchial arch anomalies.
Collapse
Affiliation(s)
- A Brad Hall
- Morsani College of Medicine, University of South Florida, United States
| | | | - Phillip Coker
- Emergency Medicine, Lakeland Regional Health, United States
| |
Collapse
|
8
|
Cordes M, Coerper S, Kuwert T, Schmidkonz C. Ultrasound Imaging of Cervical Anatomic Variants. Curr Med Imaging 2021; 17:966-972. [PMID: 33504311 PMCID: PMC8653420 DOI: 10.2174/1573405617666210127162328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 11/30/2022]
Abstract
Embryologic developmental variants of the thyroid and parathyroid glands may cause cervical anomalies that are detectable in ultrasound examinations of the neck. For some of these developmental variants, molecular genetic factors have been identified. Ultrasound, as the first-line imaging procedure, has proven useful in detecting clinically relevant anatomic variants. The aim of this article was to systematically summarize the ultrasound characteristics of developmental variants of the thyroid and parathyroid glands as well as ectopic thymus and neck cysts. Quantitative measures were developed based on our findings and the respective literature. Developmental anomalies frequently manifest as cysts that can be detected by cervical ultrasound examinations. Median neck cysts are the most common congenital cervical cystic lesions, with a reported prevalence of 7% in the general population. Besides cystic malformations, developmental anomalies may appear as ectopic or dystopic tissue. Ectopic thyroid tissue is observed in the midline of the neck in most patients and has a prevalence of 1/100,000 to 1/300,000. Lingual thyroid accounts for 90% of cases of ectopic thyroid tissue. Zuckerkandl tubercles (ZTs) have been detected in 55% of all thyroid lobes. Prominent ZTs are frequently observed in thyroid lobes affected by autoimmune thyroiditis compared with normal lobes or nodular lobes (P = 0.006). The correct interpretation of the ultrasound characteristics of these variants is essential to establish the clinical diagnosis. In the preoperative assessment, the identification of these cervical anomalies via ultrasound examination is indispensable.
Collapse
Affiliation(s)
- Michael Cordes
- Nuklearmedizinische Klinik, Universitätsklinikum Erlangen, Germany
| | - Stephan Coerper
- Klinik für Chirurgie, Martha-Maria-Krankenhaus, Nürnberg, Germany
| | - Torsten Kuwert
- Nuklearmedizinische Klinik, Universitätsklinikum Erlangen, Germany
| | | |
Collapse
|
9
|
Shehan JN, Levi JR. An unexpected cyst of the ear lobule. Am J Otolaryngol 2021; 42:102976. [PMID: 33610922 DOI: 10.1016/j.amjoto.2021.102976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 02/13/2021] [Indexed: 11/15/2022]
Abstract
Branchial cleft anomalies (BCA) are among the most common congenital anomalies found in the pediatric head and neck. The embryology of these congenital anomalies is well understood, which allows clinicians to anticipate their diagnosis when a pediatric patient presents with a head or neck mass. The predictable anatomy of the various types of BCA allows for improved surgical planning to prevent recurrence and ensure complete resection. This report details an unusual location of a first BCA located in the ear lobule of a 10-month old male. There has been no documented first BCA at the ear lobule in the literature.
Collapse
Affiliation(s)
- Jennifer N Shehan
- Boston Medical Center, Department of Otolaryngology - Head & Neck Surgery, United States of America.
| | - Jessica R Levi
- Boston Medical Center, Department of Otolaryngology - Head & Neck Surgery, United States of America; Boston University School of Medicine, Boston, MA, United States of America
| |
Collapse
|
10
|
Aleksanyan LV, Afyan TS, Khachatryan PS, Poghosyan AY. Schwannoma of the brachial plexus with cystic degeneration: A case report schwannoma of the brachial plexus. Clin Case Rep 2021; 9:1980-1985. [PMID: 33936627 PMCID: PMC8077327 DOI: 10.1002/ccr3.3922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/05/2021] [Accepted: 01/29/2021] [Indexed: 12/23/2022] Open
Abstract
Schwannoma of the brachial plexus can be present as a painless swelling without an upper limb functional or sensitivity deficiency. Thorough examinations, including MRI, are necessary to identify the nerves of origin and prevent potential harm.
Collapse
Affiliation(s)
- Lusine V. Aleksanyan
- Department of ENT and Maxillofacial Surgery "Heratsi" No. 1 University HospitalYSMUYerevanArmenia
| | - Tigran S. Afyan
- Department of ENT and Maxillofacial Surgery "Heratsi" No. 1 University HospitalYSMUYerevanArmenia
| | - Parandzem S. Khachatryan
- Department of Pathological Anatomy and Clinical Morphology "Heratsi" No. 1 University HospitalYSMUYerevanArmenia
| | - Anna Yu Poghosyan
- Department of ENT and Maxillofacial Surgery "Heratsi" No. 1 University HospitalYSMUYerevanArmenia
| |
Collapse
|
11
|
Stutsrim AE, Zeller K. Bronchogenic Cyst of the Scapula Presenting as a Superficial Abscess in a 21-Month-Old Girl. Am Surg 2020; 88:1357-1358. [PMID: 32869665 DOI: 10.1177/0003134820945207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Ashlee E Stutsrim
- 12280 Department of Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Kristen Zeller
- 12280 Department of Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| |
Collapse
|
12
|
Corvino A, Caruso M, Varelli C, Di Gennaro F, Pignata S, Corvino F, Vallone G, Catalano O. Diagnostic imaging of parotid gland oncocytoma: a pictorial review with emphasis on ultrasound assessment. J Ultrasound 2020; 24:241-247. [PMID: 32710434 DOI: 10.1007/s40477-020-00511-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/13/2020] [Indexed: 11/27/2022] Open
Abstract
Parotid gland oncocytoma (PGO) is a rare benign epithelial tumor that usually occurs in the elderly population. The most common clinical presentation is a painless, slow-growing, non-tender, lobulated, and mobile mass. Histologically, it is composed of monotonous sheets of epithelial cells (oncocytes) with a central scar. The cross-sectional appearance is not specific, and it overlaps with other parotid lesions. On ultrasound (US), oncocytoma appears as an ovoid, well-defined, homogeneous, and hypoechoic lesion. Cystic and hemorrhagic areas as well as intralesional fat may be observed. Doppler analysis shows intratumoral vessels, sometimes with a spoke-wheel pattern. The peak systolic flow is high (up to 100 cm/sec). Furthermore, oncocytoma is avid of FDG on a PET scan, as well as a malignant tumor. Thus, a combined clinical, imaging, and pathologic assessment is essential to establish the most accurate diagnosis and plan the best treatment. US, combined with Doppler techniques, can play an important role in suggesting the diagnosis and confirming it through percutaneous sampling. The purpose of this review is to show the imaging findings in PGO, with special emphasis on the US appearance.
Collapse
Affiliation(s)
- Antonio Corvino
- Motor Science and Wellness Department, University of Naples "Parthenope", via F. Acton 38, I-80133, Naples, Italy.
- , Casal di Principe, Italy.
| | - Martina Caruso
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, 80131, Naples, Italy
| | - Carlo Varelli
- Radiology Unit, Varelli Institute, via Cornelia dei Gracchi 65, 80126, Naples, Italy
| | - Francesca Di Gennaro
- Nuclear Medicine Division, Radiology and Radiotherapy Department, National Cancer Institute Pascale Foundation, via M. Semmola 53, 80131, Naples, Italy
| | - Saverio Pignata
- Ultrasound Unit, Ninetta Rosano Institute, via Capo Tirone 14, 87021, Belvedere Marittimo (CS), Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, via A. Cardarelli 9, 80131, Naples, Italy
| | - Gianfranco Vallone
- Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), via S. Pansini 5, 80131, Naples, Italy
| | - Orlando Catalano
- Radiology Unit, Varelli Institute, via Cornelia dei Gracchi 65, 80126, Naples, Italy
| |
Collapse
|
13
|
Thorpe RK, Policeni B, Eigsti R, Zhan X, Hoffman HT. CT Fistulography and Histopathologic Correlates for Surgical Treatment of Branchial Cleft Sinuses. EAR, NOSE & THROAT JOURNAL 2020; 100:976S-978S. [PMID: 32520603 DOI: 10.1177/0145561320933015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Ryan K Thorpe
- Department of Otolaryngology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Bruno Policeni
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Renee Eigsti
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Xin Zhan
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Henry T Hoffman
- Department of Otolaryngology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| |
Collapse
|
14
|
Thyroglossal duct cysts and site-specific differential diagnoses: imaging findings with emphasis on ultrasound assessment. J Ultrasound 2020; 23:139-149. [PMID: 32052384 DOI: 10.1007/s40477-020-00433-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 01/29/2020] [Indexed: 02/07/2023] Open
Abstract
Thyroglossal duct cysts (TGDCs) are the most common congenital abnormality of the neck, accounting for approximately 70% of congenital neck lesions. Two-thirds of thyroglossal duct anomalies are diagnosed within the first three decades of life, with more than half being identified before 10 years of age. The age of presentation, clinical examination and imaging are essential for an accurate diagnosis. This review aims to summarize the imaging findings of TGDCs and their main differential diagnoses with emphasis on ultrasound assessment. A focus on site-specific key differentiating between them is also addressed.
Collapse
|
15
|
Rodríguez Bandera AI, Sebaratnam DF, Feito Rodríguez M, de Lucas Laguna R. Cutaneous ultrasound and its utility in Pediatric Dermatology: Part II-Developmental anomalies and vascular lesions. Pediatr Dermatol 2020; 37:40-51. [PMID: 31742750 DOI: 10.1111/pde.13897] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
High-frequency ultrasonography represents a promising tool for pediatric dermatologists. It is a noninvasive and harmless diagnostic technique that is especially appealing when working with children. It can be easily performed at the patient's bedside, avoiding diagnostic delays, sedation, or multiple visits. It represents a useful adjunct to clinical examination and aids our understanding of cutaneous pathology. In this second part, we describe the ultrasonographic findings of developmental anomalies and vascular lesions.
Collapse
Affiliation(s)
| | - Deshan Frank Sebaratnam
- Sydney Children's Hospitals' Network, Sydney, New South Wales, Australia.,University of New South Wales, Sydney, New South Wales, Australia
| | | | | |
Collapse
|
16
|
Iaremenko AI, Kolegova TE, Sharova OL. Endoscopically-Associated Hairline Approach to Excision of Second Branchial Cleft Cysts. Indian J Otolaryngol Head Neck Surg 2019; 71:618-627. [PMID: 31742031 PMCID: PMC6848566 DOI: 10.1007/s12070-018-1439-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/29/2018] [Indexed: 10/28/2022] Open
Abstract
To improve the treatment outcome and post-operation rehabilitation of patients with second branchial cleft cysts (SBCC), 46 patients were operated for SBCC. 22 patients were operated by conventional approach, 22 patients were operated by original occipital hairline approach and 2 patients were operated via axillary approach. Assessment of intra-operation and post-operation complications was done and comparative evaluation of the preparations of the morphological structure in the main and reference group I was conducted. Clinical psychological assessment was performed in the post-operation period. Based on the clinical criteria and morphological method, the authors made conclusions on the benefits of the proposed approach to the excision of SBCC and determined indications and contraindications to endoscopically-associated surgery via the proposed approach. Comparative analysis of beneficial outcome clinically significant criteria of the conventional, axillary and proposed original approaches showed differences in the following criteria: "average operation time", "average wound dressing duration", "average duration of hospitalization" and "subjective satisfaction with incision scar". There were no differences revealed in the criteria "average incision length". The proposed approach allowed the authors to shorten the treatment duration and to accelerate the patients port-operation recovery. Due to the proposed approach, the incision opened the fascial layer where the cyst was located. The dissection was performed along the hairline and did not involve upper and lower located layers. Minimal surgery traumatic rate of the proposed approach was proved by the morphological studies.
Collapse
Affiliation(s)
- Andrei I. Iaremenko
- Department of Oral and Maxillofacial Surgery, Pavlov First Saint Petersburg State Medical University, 6-8 Lva Tolstogo Str., Saint Petersburg, Russian Federation 197022
| | - Tatiana E. Kolegova
- Clinics of Maxillofacial Surgery, Pavlov First Saint Petersburg State Medical University, 6-8 Lva Tolstogo Str., Saint Petersburg, Russian Federation 197022
| | - Olga L. Sharova
- National Center for Clinical Morphological Diagnostics, Llc, 6H 8/2A Oleko Dundicha Street, Saint Petersburg, Russian Federation 192283
| |
Collapse
|
17
|
Cystic form of cervical lymphadenopathy. Guidelines of the French Society of Otorhinolaryngology - Head and Neck Surgery (SFORL). Part 1: Diagnostic procedures for lymphadenopathy in case of cervical mass with cystic aspect. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:489-496. [PMID: 31186166 DOI: 10.1016/j.anorl.2019.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The authors present the guidelines of the French Society of Otorhinolaryngology - Head and Neck Surgery Society on diagnostic procedures for lymphadenopathy in case of a cervical mass with cystic aspect. METHODS A multidisciplinary work-group was entrusted with a review of the scientific literature on the topic. Guidelines were drawn up, then read over by an editorial group independent of the work-group, and the final version was drawn up. Guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence. RESULTS In adults presenting a cystic cervical mass, it is recommended to suspect cervical lymphadenopathy: in order of decreasing frequency, cystic metastasis of head and neck squamous cell carcinoma, of undifferentiated nasopharyngeal carcinoma, and of thyroid papillary carcinoma (Grade C). On discovery of a cystic cervical mass on ultrasound, architectural elements indicating a lymph node and a thyroid nodule with signs of malignancy should be screened for, especially if the mass is located in levels III, IV or VI (Grade A). Malignant lymphadenopathy should be suspected in case of cervical mass with cystic component on CT (Grade B), but benign or malignant status cannot be diagnosed only on radiological data (CT or MRI) (Grade A), and 18-FDG PET-CT should be performed, particularly in case of inconclusive ultrasound-guided fine needle aspiration biopsy (Grade C).
Collapse
|
18
|
Affiliation(s)
- Ryohei Ono
- Department of General Internal Medicine, Shonan Kamakura General Hospital, Japan
| | - Izumi Kitagawa
- Department of General Internal Medicine, Shonan Kamakura General Hospital, Japan
| | - Hiroshi Osafune
- Department of Otorhinolaryngology, Shonan Kamakura General Hospital, Japan
| |
Collapse
|
19
|
Bocchialini G, Bozzola A, Daleffe F, Ferrari L, Castellani A. Unusually rapid development of a lateral neck mass: Diagnosis and treatment of a branchial cleft cyst. A case report. Int J Surg Case Rep 2017; 41:383-386. [PMID: 29545997 PMCID: PMC5697997 DOI: 10.1016/j.ijscr.2017.10.065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 10/25/2017] [Accepted: 10/26/2017] [Indexed: 11/26/2022] Open
Abstract
Introduction Branchial cleft cysts are benign lesions caused by anomalous development of the branchial cleft. Cases that arise in the lateral neck region are often misdiagnosed, resulting initially in inappropriate management. Case presentation We describe a 32-year-old woman with a swelling on the right side of her neck and no pain during palpation or neck motion. Discussion The patient was evaluated using fine-needle aspiration cytology (FNAC), ultrasound, and magnetic resonance imaging (MRI) scans. The MRI showed a right-sided cervical mass with hyperintense content, well-defined margins, and no evidence of infiltration into surrounding structures, while FNAC found a yellow, pus-like fluid, keratinised anuclear cells, squamous epithelium, and a matrix of amorphous debris. Conclusion Based on the images and the patient's symptoms, a surgical intervention was performed.
Collapse
Affiliation(s)
| | - Anna Bozzola
- Department of Molecular and Translational Medicine, Section of Pathology, University Spedali Civili Di Brescia, Spedali Civili di Brescia, Unità Operativa di Anatomia Patologica, Brescia, Italy
| | | | - Luca Ferrari
- Maxillo-Facial Pediatric Surgery Unit, ASST Spedali Civili, Brescia, Italy
| | | |
Collapse
|
20
|
Bhatt S, Verma P, Meena N, Tandon A, Tanveer N, Bansal D. Glomus vagale tumour, can it be diagnosed only on sonography? J Ultrasound 2017; 20:73-79. [PMID: 28298947 DOI: 10.1007/s40477-016-0237-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 09/25/2016] [Indexed: 10/20/2022] Open
Abstract
Vagal paragangliomas are rare benign tumors accounting for only 3% of head and neck paragangliomas and arise from vagal ganglions, predominately the nodose ganglion in the carotid sheath. Imaging plays an important role in their diagnosis, differentiation from more common lesions presenting in the carotid space, and management. MRI is the method of choice for investigation when paragangliomas are clinically suspected. The typical salt-and-pepper appearance in T1-weighted images is well known but not specific to paragangliomas. Demonstration of the continuity of the lesion with the vagus nerve on magnetic resonance imaging (MRI) further asserts the diagnosis of glomus vagale. Although this tumor can be diagnosed on a contrast-enhanced computed tomography (CECT) examination, it is limited by the non-demonstration of its neural origin. Sonography is considered only a preliminary investigation in patients, and a CECT and/or MRI study of the neck is conducted before treatment planning. This case is unique as a confident diagnosis of glomus vagale was made on high-resolution sonography of the neck. A middle-aged male patient presenting with a neck swelling was diagnosed with a glomus vagale tumor on USG by the direct demonstration of its continuity with the vagus nerve, and Doppler examination confirmed its vascularity. The diagnosis was confirmed on histopathology after surgical excision. The sonographic appearance, Doppler characteristics, and imaging differential diagnosis of glomus vagale are discussed in detail.
Collapse
Affiliation(s)
- Shuchi Bhatt
- Department of Radio-diagnosis, University College of Medical sciences (University of Delhi) and GTB Hospital, Dilshad Garden, Delhi, 110095 India
| | - Pooja Verma
- Department of Radio-diagnosis, University College of Medical sciences (University of Delhi) and GTB Hospital, Dilshad Garden, Delhi, 110095 India
| | - Neha Meena
- Department of Radio-diagnosis, University College of Medical sciences (University of Delhi) and GTB Hospital, Dilshad Garden, Delhi, 110095 India
| | - Anupama Tandon
- Department of Radio-diagnosis, University College of Medical sciences (University of Delhi) and GTB Hospital, Dilshad Garden, Delhi, 110095 India
| | - Nadeem Tanveer
- Department of Pathology, University College of Medical Sciences (University of Delhi) and GTB Hospital, Dilshad Garden, Delhi, 110095 India
| | - Divya Bansal
- Department of Pathology, University College of Medical Sciences (University of Delhi) and GTB Hospital, Dilshad Garden, Delhi, 110095 India
| |
Collapse
|
21
|
Lymphoepithelial Cyst in the Palatine Tonsil. Case Rep Otolaryngol 2016; 2016:6296840. [PMID: 27722002 PMCID: PMC5046002 DOI: 10.1155/2016/6296840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 08/14/2016] [Indexed: 11/18/2022] Open
Abstract
Lymphoepithelial cyst (LEC) is the most commonly encountered congenital neck pathology in the lateral part of the neck. A 66-year-old woman presented to the ENT clinic due to difficulty in swallowing persisting for approximately 1 year. Magnetic resonance imaging revealed a cystic mass at right tonsil. Surgery was performed due to this unilateral tonsillar mass, which was excised together with the right tonsil. LEC was diagnosed at histopathological examination. LEC in the palatine tonsil is rare, and only a few cases have been reported in the literature. We report a rare case of LEC in the palatine tonsil.
Collapse
|
22
|
Spinelli C, Rossi L, Strambi S, Piscioneri J, Natale G, Bertocchini A, Messineo A. Branchial cleft and pouch anomalies in childhood: a report of 50 surgical cases. J Endocrinol Invest 2016; 39:529-35. [PMID: 26403983 DOI: 10.1007/s40618-015-0390-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 09/10/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Branchial abnormalities occur when there is disturbance in the maturation of the branchial apparatus during fetal development. Branchial anomalies are congenital lesions usually present in childhood, even if they can be diagnosed later for enlargement or infection. A correct diagnosis will lead to proper management: complete surgical excision is the treatment of choice. The purpose of this article is to present clinical features, diagnostic methods and surgical treatment of branchial anomalies in childhood, based on a series of 50 patients. METHODS We conducted a retrospective analysis of a total of 50 pediatric patients operated from June 2005 to June 2014 for the presence of branchial cleft anomalies. RESULTS 27 cases (54 %) presented a second branchial cleft fistula and 11 cases (22 %) a second branchial cleft cyst and one case (2 %) presented both cyst and sinus of the second branchial cleft; four cases (8 %) presented first branchial cleft cyst whereas four cases (8 %) a first branchial cleft sinus and two cases (4 %) a first branchial cleft fistula; one case (2 %) presented a piriform sinus fistula (third branchial cleft). None of our patients presented anomalies of the fourth branchial cleft. All patients underwent surgical treatment and lesions have been removed by excision or fistulectomy. No post-surgical complication occurred. The rate of recurrence was 4 %. CONCLUSIONS Pre-operative diagnosis supplies important information to the surgeon for a proper therapy: a complete excision of the lesion without inflammatory signs is essential to avoid re-intervention and to achieve a good outcome.
Collapse
Affiliation(s)
- C Spinelli
- Department of Surgical, Medical, Pathological, Molecular and Critic Area-Chair of Pediatric Surgery, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
| | - L Rossi
- Department of Surgical, Medical, Pathological, Molecular and Critic Area-Chair of Pediatric Surgery, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - S Strambi
- Department of Surgical, Medical, Pathological, Molecular and Critic Area-Chair of Pediatric Surgery, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - J Piscioneri
- Department of Surgical, Medical, Pathological, Molecular and Critic Area-Chair of Pediatric Surgery, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - G Natale
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, 56126, Pisa, Italy
| | - A Bertocchini
- Department of Pediatric Surgery, Children's Hospital A. Meyer, University of Florence, Via Luca Giordano 13, 50132, Florence, Italy
| | - A Messineo
- Department of Pediatric Surgery, Children's Hospital A. Meyer, University of Florence, Via Luca Giordano 13, 50132, Florence, Italy
| |
Collapse
|