A Clinical Analysis of Pharyngeal Bronchogenic Cysts in the Pharynx of Children.

Ying Xu,Shengcai Wang,Jie Zhang,Xin Ni,Dongjie Seng,Lan Jiang,Fugen Han

doi:10.3389/fped.2021.629009

Abstract

Objective: This study was designed to summarize the clinical characteristics, diagnosis and treatment of pharyngeal bronchogenic cysts in children to help in making the correct diagnosis and developing an appropriate treatment plan.Methods: The clinical data of 13 children with bronchogenic cysts in the pharynx, who were treated in otolaryngology head and neck surgery department between September 2013 and July 2019, were analyzed retrospectively. The clinical characteristics were evaluated, and the related factors for diagnosis and treatment were analyzed. Clinical characteristics and imaging features of three cases whose lesions located in the nasopharyngeal, oropharynx, and laryngopharyngeal were demonstrated.Results: All 13 children were male, the youngest being 4 days old, the oldest 6 years and 6 months, and the median age being 1 year and 4 months. Eight patients were diagnosed during a physical examination, and five patients visited the doctor with different degrees of upper airway obstruction. The mass was located in the nasopharynx in one patient, in the oropharynx in eight patients, and in the laryngopharynx in the other four patients. Computed tomography (CT) scanning, which is helpful for a topical diagnosis, showed a dense homogeneous mass. Electronic nasopharyngoscopy showed cystic masses of different sizes in the pharynx. All the children underwent cyst resection under general anesthesia, and the postoperative pathology result was a bronchogenic cyst. One child was lost to follow-up, but the remaining 12 children were followed up for between 6 months and 6 years, during which no recurrence of a cyst was found.Conclusion: Bronchogenic cysts are a rare cyst of the head and neck, and the most common site of the cyst is the oropharynx. The impact on airway obstruction depends on the location and size of the cyst. CT scanning is of great significance for diagnosis. Surgical treatment should be carried out as soon as possible after diagnosis, as surgery is the most effective way to treat bronchogenic cysts. Follow-ups should be carried out regularly to prevent cyst recurrence.

Highlights

Bronchogenic cysts are a rare congenital disease resulting from the abnormal development of primitive foregut, and they occur in one or more tissues of the respiratory system
Eight patients were diagnosed during a physical examination, while five patients visited the doctor with varying degrees of upper airway obstruction and underwent electronic nasopharyngoscopy, computed tomography (CT), and Magnetic Resonance Imaging (MRI)
Three children visited the doctor with progressive dyspnea and snoring, and masses were found at the root of the tongue and epiglottis valley

Summary

Introduction

Bronchogenic cysts are a rare congenital disease resulting from the abnormal development of primitive foregut, and they occur in one or more tissues of the respiratory system. The pathogenesis is unknown, the hypothesis of embryo abscission and translocation proposed by Govaerts et al is generally accepted [1]. It suggests that in the early stage of embryo development, the thorax and abdominal cavity are integrated, and the primary tracheobronchial tree is formed in the 5th week. During this period, all types of abnormal germs fall off and migrate, and since the secretions cannot be discharged, a bronchogenic cyst forms at the migration site. The data of 13 cases of bronchogenic cysts in the pharynx were analyzed, and the clinical characteristics and diagnosis and treatment were summarized to improve the preoperative diagnosis rate of the disease and help in improving treatment plans

Methods

Results

Discussion

Conclusion