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Tandan N, Saini A, Verma H, Thakar A. Nasopharyngeal Cyst Causing Hearing Loss: Case Report and Review of Literature. Indian J Otolaryngol Head Neck Surg 2024; 76:775-780. [PMID: 38440445 PMCID: PMC10908969 DOI: 10.1007/s12070-023-04279-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/08/2023] [Indexed: 03/06/2024] Open
Abstract
Symptomatic nasopharyngeal cysts are relatively uncommon. Here is a case report of 50 years of age female with hearing loss secondary to the nasopharyngeal cyst. She underwent endoscopic marsupialization and achieved normal hearing postoperatively.The study aims to determine the incidence of hearing loss, radiological patterns and histopathological findings associated with the nasopharyngeal cyst.
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Affiliation(s)
- Nisha Tandan
- All India Institute of Medical Sciences, E 20, AV nagar, New Delhi, India
| | - Ashish Saini
- All India Institute of Medical Sciences, E 20, AV nagar, New Delhi, India
| | - Hitesh Verma
- All India Institute of Medical Sciences, E 20, AV nagar, New Delhi, India
| | - Alok Thakar
- All India Institute of Medical Sciences, E 20, AV nagar, New Delhi, India
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Trac J, Routhier-Chevrier B, Chen H, Propst EJ, Wolter NE. Salivary gland anlage tumor: Evaluation and management of a rare pediatric condition. Int J Pediatr Otorhinolaryngol 2022; 163:111370. [PMID: 36327911 DOI: 10.1016/j.ijporl.2022.111370] [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: 08/07/2022] [Revised: 10/05/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Neonates and infants are obligatory nasal breathers. Nasal obstruction can therefore be life-threatening and prompt recognition of its cause is critical. Salivary gland anlage tumor (SGAT) is a rare, benign condition that can present with nasal obstruction and respiratory distress within the first weeks of life. Our objective was to outline the clinical presentation, evaluation, and management of SGAT and provide a review of existing literature. METHODS A retrospective chart review was performed at a tertiary children's hospital. A comprehensive literature search for SGAT was conducted using Medline, Embase, PubMed, and EBSCO. We present a case from our institution to describe the clinical approach to SGAT. RESULTS Forty-one cases of previously reported SGAT, plus our new patient, were included. Patients presented with respiratory distress (30/42, 71.4%), feeding difficulty (14/42, 33.3%) and/or upper airway obstruction (13/42, 31.0%). The majority of tumors were in the nasopharynx (25/42, 59.5%). Surgical excision (36/42, 85.7%) was most commonly performed. Surgical approaches have evolved to include transoral, transpalatal, transnasal endoscopic or a combination of the above. Our patient had a suspected residual/recurrent tumor, later found to be negative on pathology. To date, there have been no reported recurrences. CONCLUSIONS SGAT is a rare pediatric condition that is often excluded from the differential diagnosis of nasal obstruction. Clinical evaluation includes flexible nasopharyngoscopy and neuroimaging. Management involves surgical resection, except in cases of spontaneous expulsion. Tissue pathology is required for definitive diagnosis. Tissue biopsy should be performed on follow-up if there is a suspicion for recurrence.
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Affiliation(s)
- Jessica Trac
- Temerty Faculty of Medicine, University of Toronto, Canada
| | | | - Haiying Chen
- Department of Laboratory Medicine and Pathobiology, The Hospital for Sick Children, University of Toronto, Canada
| | - Evan J Propst
- Department of Otolaryngology - Head and Neck Surgery, The Hospital for Sick Children, University of Toronto, Canada
| | - Nikolaus E Wolter
- Department of Otolaryngology - Head and Neck Surgery, The Hospital for Sick Children, University of Toronto, Canada.
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Radiologic evaluation of the fossa navicularis: incidence, morphometric features, and clinical implications. Surg Radiol Anat 2021; 43:1887-1893. [PMID: 33860857 DOI: 10.1007/s00276-021-02742-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The aim of this study was to determine the incidence and morphometric and morphological characteristics of fossa navicularis (FN) on cone beam computed tomography (CBCT) images of healthy adults MATERIALS AND METHODS: CBCT images of 900 individuals (450 males, 450 females, over the age of 18) admitted to Gaziantep University, Dentistry Faculty were retrospectively examined. The incidence and shape of FN were determined. Transverse diameter (TDFN), sagittal diameter (SDFN), depth in transverse section (DFNT), depth in sagittal section (DFNS), and the shortest distance between the deepest point of FN and intracranial cavity (FNI) were measured. RESULTS FN was detected in 122 (59 males and 63 females) of 900 (13.56%) CBCT images. No statistically significant difference was observed between gender and the incidence of FN. SDFN, TDFN, DFNS, DFNT and FNI were measured as 4.04 ± 1.71, 4.28 ± 1.34, 1.79 ± 0.68, 2.34 ± 0.85, and 6.76 ± 2.23 mm, respectively. Besides, FN was described as oval in 95 of 122 (77.87%) cases, while as round in 27 (22.23%) cases. CONCLUSIONS The incidence of FN is rare; however, it may be responsible for serious consequences by causing infections from the nasopharynx to the intracranial cavity. As far as we know, the distance between the deepest point of FN and the intracranial cavity was measured for the first time in the literature with this study.
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Alshuhayb Z, Alkhamis H, Aldossary M, Almoumen Z, Aldhurais A, Alshuhayb B, Almomen A. Tornwaldt nasopharyngeal cyst: Case series and literature review. Int J Surg Case Rep 2020; 76:166-169. [PMID: 33039780 PMCID: PMC7550824 DOI: 10.1016/j.ijscr.2020.09.105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/16/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Tornwaldt cyst (TC) is a relatively rare but benign disease. Although these lesions are asymptomatic and found incidentally during routine ENT examination, the can present with unexplained sinonasal symptoms, such as nasal obstruction, post nasal drip and occipital headache. AIM To study the clinical presentations and outcome of Tornwaldt nasopharyngeal cyst cases diagnosed and managed in our center. METHODS Patients with symptomatic TC who were operated and followed up at our center were selected for this study. RESULTS 3 patients with a diagnosis of TC by naso-endoscopy, CT and MRI were included in this study. All patients were males, with age ranging from 54 to 86 years. A trans-nasal endoscopic surgical removal of the cyst was done for all patients with no intra or post-operative complications. All patients were free of symptoms and disease reassurance at follow up. CONCLUSION Although relatively rare, TC should be suspected in any patient complaining of unexplained sinonasal symptoms. Endoscopic surgical excision is a safe and effective maneuver with no cyst recurrence.
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Affiliation(s)
| | | | | | | | | | | | - Ali Almomen
- Rhinology and Endoscopic Skull Base Surgery at King Fahad Specialist Hospital, Dammam, Saudi Arabia.
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Jain N, Singh L, Roy S. Nasopharyngeal pituitary in newborn: A diagnostic dilemma. OTOLARYNGOLOGY CASE REPORTS 2019. [DOI: 10.1016/j.xocr.2019.100121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kryukov AI, Kunel'skaya NL, Tsarapkin GY, Tovmasyan AS, Kishinevsky AE. [Observation of the intra-adenoid cysts in the nasopharynx]. Vestn Otorinolaringol 2018; 83:68-71. [PMID: 29488503 DOI: 10.17116/otorino201883168-71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of the present study was to demonstrate the clinical significance and possibilities of diagnostics and treatment of the intra-adenoid cysts in the nasopharynx as exemplified by an original observation of an individual case. The cystic structures in the nasopharynx rarely manifest themselves clinically and are known to produce the non-specific symptoms. The patients admitted to the L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology for the surgical treatment of nasopharyngeal cysts account for 0.05% of the total number of the hospitalized subjects. This article reports a case of two large intra-adenoid cysts in the nasopharynx of one patient complicated by bilateral exudative otitis media. The successful outcome of the surgical treatment of this condition was achieved by means of endonasal marsupilization of the cysts under the laser-assisted endoscopic control with simultaneous bilateral shunting of the tympanic cavity.
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Affiliation(s)
- A I Kryukov
- Department of Otorhinolaryngology, N.I. Pirogov Russian National Research Medical University, Moscow, Russia, 117997; L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - N L Kunel'skaya
- Department of Otorhinolaryngology, N.I. Pirogov Russian National Research Medical University, Moscow, Russia, 117997; L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - G Yu Tsarapkin
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - A S Tovmasyan
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - A E Kishinevsky
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
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Ata N. Unilateral Nasal Obstruction Caused by a Large Nasopharyngeal Cyst. Eurasian J Med 2018. [PMID: 29531499 DOI: 10.5152/eurasianjmed.2018.17341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Nurdogan Ata
- Department of Otorhinolaryngology, Medicana Konya Hospital, Konya, Turkey
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Tsarapkin GY, Tovmasyan AS, Arzamazov SG, Kishinevskii AE. [Differential diagnostics and the treatment strategy for the management of the nasopharyngeal cystic lesions]. Vestn Otorinolaringol 2017; 82:52-55. [PMID: 28980598 DOI: 10.17116/otorino201782452-55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The nasopharyngeal cystic lesions are quite common (affecting up to 14% of the general population) even though the majority of the cases are asymptomatic. Sometimes this condition is associated with the obstruction of nasal breathing, runny nose, hearing impairment, and other non-specific clinical manifestations. The endoscopic examination of the nasal cavity allows the preliminary clinical diagnosis to be established, however, MRI and CT visualization are necessary for more reliable differential diagnostics of this pathology and adequate planning of its treatment. The nasopharyngeal cysts require the surgical treatment, with endoscopic transnasal marsupialization in the combination with coblation, radiowave or laser irradiation being the main currently available option.
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Affiliation(s)
- G Yu Tsarapkin
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - A S Tovmasyan
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - S G Arzamazov
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - A E Kishinevskii
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
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Sheikh S, Iwanaga J, Rostad S, Rustagi T, Oskouian RJ, Tubbs RS. The First Histological Analysis of the Tissues Lining the Fossa Navicularis: Insights to its Etiology. Cureus 2017; 9:e1299. [PMID: 28680787 PMCID: PMC5493477 DOI: 10.7759/cureus.1299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The fossa navicularis (FN) is an anatomical variant on the ventral surface of the basilar part of the occipital bone that, to date, has only been investigated in bone specimens. We aim to clarify the structure of the fossa navicularis by gross anatomical, radiological, and histological methods. The FN was found in the occipital bone of the Caucasian male cadaver. There was no bony or histological continuity between the FN and posterior cranial fossa. The histological analysis found that the overlying tissue was composed of loose connective tissue with a mixture of collagen and elastic fibers and a vascular matrix including arteries, veins, and capillaries. There was no evidence of lymphoid, glandular, or notochordal tissues. As no previous studies have performed histological analysis of the FN, this report adds to our knowledge of tissues that are involved in its formation.
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Affiliation(s)
| | | | | | | | - Rod J Oskouian
- Neurosurgery, Complex Spine, Swedish Neuroscience Institute
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Stoddard DG, Pallanch JF, Hamilton GS. The effect of vibrissae on subjective and objective measures of nasal obstruction. Am J Rhinol Allergy 2016; 29:373-7. [PMID: 26358350 DOI: 10.2500/ajra.2015.29.4209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Nasal congestion and/or obstruction represents a prevalent and extensively studied problem. No published research exists that describes the impact of nasal hair (vibrissae) on nasal obstruction. OBJECTIVE To assess the impact of nasal vibrissae on subjective and objective measurements of nasal obstruction. METHODS In this prospective study, 30 healthy participants without nasal symptoms were assessed for baseline vibrissae density and were treated with a topical decongestant. The subjects were then asked to subjectively assess nasal breathing by using four questions from the Nasal Obstruction Symptom Evaluation instrument before undergoing rhinomanometry. Nasal vibrissae were then trimmed, and the participants repeated the subjective and objective assessments. Pre- and postintervention outcomes, including symptom scores, nasal airflow, and resistance, were compared by using statistical analysis. RESULTS Statistically significant improvement was noted in subjects' nasal airway specific symptom scores and in objective measurements of their nasal airway. Patients with moderate or many vibrissae at baseline were noted to have greater likelihood of improvement in subjective and objective obstruction assessments than patients rated with few. CONCLUSION In these 30 subjects, statistically significant improvement occurred in both subjective and objective assessments of nasal obstruction, particularly in patients with greater density of vibrissae. These findings support further study of the potential benefit of the reduction of vibrissae density in some patients with nasal obstruction.
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Affiliation(s)
- David G Stoddard
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA
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Syed AZ, Mupparapu M. Fossa navicularis magna detection on cone-beam computed tomography. Imaging Sci Dent 2016; 46:47-51. [PMID: 27051639 PMCID: PMC4816771 DOI: 10.5624/isd.2016.46.1.47] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 09/27/2015] [Accepted: 10/10/2015] [Indexed: 12/20/2022] Open
Abstract
Herein, we report and discuss the detection of fossa navicularis magna, a close radiographic anatomic variant of canalis basilaris medianus of the basiocciput, as an incidental finding in cone-beam computed tomography (CBCT) imaging. The CBCT data of the patients in question were referred for the evaluation of implant sites and to rule out pathology in the maxilla and mandible. CBCT analysis showed osseous, notch-like defects on the inferior aspect of the clivus in all four cases. The appearance of fossa navicularis magna varied among the cases. In some, it was completely within the basiocciput and mimicked a small rounded, corticated, lytic defect, whereas it appeared as a notch in others. Fossa navicularis magna is an anatomical variant that occurs on the inferior aspect of the clivus. The pertinent literature on the anatomical variations occurring in this region was reviewed.
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Affiliation(s)
- Ali Z Syed
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Mel Mupparapu
- Division of Radiology, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
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Hemmaoui B, Sahli M, Jahidi A, Benariba F. Nasopharyngeal branchial cyst. Eur Ann Otorhinolaryngol Head Neck Dis 2014; 131:321-2. [PMID: 25002373 DOI: 10.1016/j.anorl.2014.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 12/23/2013] [Accepted: 01/30/2014] [Indexed: 11/19/2022]
Affiliation(s)
- B Hemmaoui
- Service d'ORL et chirurgie cervico-faciale, hôpital d'instruction militaire Mohamed V, BP 1018, Hay Riad, Rabat, Morocco.
| | - M Sahli
- Service d'ORL et chirurgie cervico-faciale, hôpital d'instruction militaire Mohamed V, BP 1018, Hay Riad, Rabat, Morocco
| | - A Jahidi
- Service d'ORL et chirurgie cervico-faciale, hôpital d'instruction militaire Mohamed V, BP 1018, Hay Riad, Rabat, Morocco
| | - F Benariba
- Service d'ORL et chirurgie cervico-faciale, hôpital d'instruction militaire Mohamed V, BP 1018, Hay Riad, Rabat, Morocco
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Palacios E, Ellis M, Neitzschman H. Hearing loss secondary to a nasopharyngeal retention cyst. EAR, NOSE & THROAT JOURNAL 2013; 91:468-72. [PMID: 23288790 DOI: 10.1177/014556131209101105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Enrique Palacios
- Department of Radiology, Tulane University Hospital and Clinics, New Orleans, LA, USA
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Two cases of nasopharyngeal branchial cleft cyst treated by powered instrument assisted marsupialisation. The Journal of Laryngology & Otology 2013; 127:614-8. [PMID: 23631955 DOI: 10.1017/s0022215113000959] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We report two extremely rare cases of symptomatic nasopharyngeal branchial cleft cyst treated by powered instrument assisted marsupialisation. METHODS Case report and literature review concerning nasopharyngeal branchial cleft cyst and surgical treatment methods. RESULTS The first case was a two-year-old boy with a 1 × 2 cm, cystic, oropharyngeal mass, who also had severe snoring and sleep apnoea. The second case was a 56-year-old man with right nasal obstruction and a sensation of fullness in the right ear. In both cases, we performed endoscopic marsupialisation using a powered instrument. There was no recurrence in either case over two years of follow up. CONCLUSION Powered instrument marsupialisation is a simple, effective and less invasive technique for the treatment of nasopharyngeal branchial cleft cyst.
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Osborn MF, Buchanan BK, Akle N, Badr A, Zhang J. Embryologic Association of Tornwaldt's Cyst with Cerebral Artery Abnormalities and Infarction: A Case Report. Case Rep Pediatr 2012; 2012:129503. [PMID: 23094173 PMCID: PMC3472527 DOI: 10.1155/2012/129503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 09/16/2012] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose. Tornwaldt's cysts are rare nasopharyngeal lesions that develop from remnants of the embryonic notochord. Summary of Case. We reported a twelve-year-old female stroke patient with Tornwaldt's cysts, whose father also suffered a stroke at age fifty two with the presence of an abdominal aortic aneurysm, suggesting a genetic influence in this case. Conclusions. This paper suggests an etiologic connection between Tornwaldt's cysts and cerebral vasculature abnormalities by way of notochordal dysfunction during development, likely the result of perturbation of notochord-derived molecular cues during development or biogenesis.
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Affiliation(s)
- Michael F. Osborn
- COE in Neurosciences and Departments of Anesthesiology and Biomedical Sciences, Texas Tech University Health Science Center, El Paso, TX 79905, USA
| | - Benjamin K. Buchanan
- COE in Neurosciences and Departments of Anesthesiology and Biomedical Sciences, Texas Tech University Health Science Center, El Paso, TX 79905, USA
| | - Nassim Akle
- Department of Radiology, Texas Tech University Health Science Center, El Paso, TX 79905, USA
| | - Ahmed Badr
- COE in Neurosciences and Departments of Anesthesiology and Biomedical Sciences, Texas Tech University Health Science Center, El Paso, TX 79905, USA
| | - Jun Zhang
- COE in Neurosciences and Departments of Anesthesiology and Biomedical Sciences, Texas Tech University Health Science Center, El Paso, TX 79905, USA
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Garetier M, Breton S, Conan-Charlet V, Pennaneach A, Garrigues F, Forlodou P, Marianowski R. [Heterotopic nasopharyngeal neuroglial tissue]. ACTA ACUST UNITED AC 2011; 92:722-4. [PMID: 21819914 DOI: 10.1016/j.jradio.2011.03.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 03/27/2011] [Accepted: 03/31/2011] [Indexed: 11/17/2022]
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