Clinical case of branchial cleft cyst in the nasopharynx and its impact on the craniofacial development

Introduction Branchial cleft cysts are congenital developmental defects of which second branchial anomalies are the most common type.Most of these anomalies present as a lateral neck mass along the anterior border of sternocleidomastoid muscle and their presentations in the nasopharynx is considered extremely rare.The symptoms generally arise late and the tumor growth leads to impaired nasal breathing,ear fullness and hearing loss.The presence of formation in the epipharynx requires careful examination and diagnosis,followed by histological verification.The presence of a mass in the nasopharynx leads to impaired nasal breathing and this in turn leads to a functional adaptations which lead to subsequent changes in craniofacial development.

Materials and methods A 32-years old woman came to the ENT department with history of impaired nasal breathing,ear fullness and pain in the left ear.Microotoscopy was carried out with a subsequent myringotomy ,which showed purulent inflammation of the middle ear.A nose endoscopy was performed .The presence of tumor formation was found.On the performed MRI it is presented as a complex structure with available cystic components engaging the area of the nasopharynx .

Results An endoscopic endonasal marsupialisation of the cyst was made.Histopathological examination revealed a branchial cleft cyst.The patient was discharged on the 3^th day without any complications.Follow up after eight months showed no evidence of recurrence and significantly improved nasal breathing.

Conclusion Due to nasal breathing occur typical oral and extraoral signs. ENT specialists and pediatric dentists should strive to diagnose mouth-breathing in children as early as possible and collaborate with a multidisciplinary team to correct its future consequences.

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Publication History

Article published online:
10 June 2020