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November 27, 2016 00:18

Median cyst of the neck

Congenital malformations in children are rare, benign tumors, cysts, which are included in the category of pathologies embryogenesis, according to statistics are no more than 5% of tumors Chloe (maxillofacial), however, are quite serious illnesses, asymptomaticmoreover, difficult to diagnose.Median cyst of the neck can be formed at an early stage of embryo development - from 3rd to 5th week of pregnancy, clinically manifest at any age, but more often during intensive growth or during hormonal changes in the body.Median cyst in medical practice is often called tireoglossalnoy, this is due to its etiology and pathogenesis of the specifics.

reasons median neck cyst

median cyst Etiology is still the subject of scientific debate, obviously due to the fact that this congenital anomaly is quite rare.Statistically median cyst takes no more than 2-3% of all tumors of the neck, respectively, to explore the possibility of a neoplasm in full and confirm the etiology of multiple clinical observation is not pos

sible.It is believed that tireoglossalnye benign tumor - a pathology embryonic basis for the formation of the maxillofacial region, ie anomalies gill apparatus.

  1. Some doctors support the version stating that the reasons for the median neck cyst lie in nezaroschennom

timely ductus thyreoglossus - thyroglossal duct or duct of the thyroid gland.This theory in the XIX century, put forward a well-known German physician, anatomist, a specialist in the study of embryogenesis, Wilhelm Giese.His name and call a specific channel that connects the thyroid gland and the embryo of the oral cavity, which is reduced in the last period of fetal development.Channel branch block or thyroglossal duct may be a source of formation of cysts and median, tireoglossalnyh fistula.

  1. reasons medial neck cysts and can be explained by a different version, also deserves attention.At the end of the XIX century, prominent surgeon Venglovsky offered his own version explaining the etiology of tireoglossalnyh tumors, according to which they are formed from the oral epithelium, with thyroglossal duct tyazhem replaced.

Obviously, these two hypotheses need further study and clinical evidence, and causes the median neck cyst will soon be clarified.

However, the first option is more reliable branch block in a statistical sense - more than 55% of diagnosed cases showed a close relationship with the median cyst hyoid bone and the foramen cecum linguae, - blind hole language that is fully consistent with the topography of ductus thyreoglossus - thyroid bud.

Symptoms median neck cyst

Clinical manifestations of congenital malformations of the neck is almost always hidden in the initial stage of development.Very rarely there are cases when the median neck cyst symptoms are visible to the naked eye in the first months after birth.More often, the cyst appears between the ages of 5 to 14-15 years of age and older.The feature of almost all types of benign tumors of the neck - is asymptomatic, which can last for many years.Median cyst in a latent state is not manifested by pain, it does not cause dysfunction of nearby structures.Start its development can give acute inflammatory disease, as well as periods of hormonal changes the body, such as puberty.Even appearing cyst grows very slowly, on palpation is defined as a circular formation on a flexible median line of the neck, the tumor is not soldered to the skin, in the process of swallowing can be moved up along with the hyoid bone and the surrounding tissue.Objective complaint from the patient begin when the cyst becomes infected, inflamed and interfere with eating.The tumor can be opened to the outside, at least in the mouth, releasing a purulent exudate, but fistula never grows independently and remain as a permanent channel for efflux of inflammatory secretory fluids.Out of fluid reduces the size of the brush, but does not contribute to its resorption.Moreover, the tumor that is diagnosed and removed in a timely manner, can provoke serious problems with swallowing food, speech impairments (diction), in rare cases - malignancy that is escalating in the malignant process.

Median cyst of the neck of the child

Despite the fact that according to statistics the median cyst of the neck of the child has very rarely - only 1 in 3,000-3,500 newborn babies, the disease remains a serious birth defects that require differential diagnosisand the inevitable surgery.

Symptoms median cyst in a child is rarely seen in the first years of life, most tumors are diagnosed in the period of intensive growth - between the ages of 4 to 7-8 years and later in adolescence.

Etiology median cyst presumably due to incomplete coalescence tireoglossalnogo duct and close ties to the hyoid bone.

Typically, in the initial period of the median cyst on the neck of a child diagnosed with random inspections, when attentive doctor carefully palpates the lymph nodes and the neck.Palpation painless cyst is felt as a dense, well-rounded education outlined by the small size.

clinical picture, which more clearly shows signs tireoglossalnoy cysts, may be associated with inflammatory, infectious process in the body, thus increasing the cyst may fester.Such developments manifest visible symptoms - increase in area in the middle of the neck, low-grade body temperature, transient pain at this point, difficulty swallowing food, even a liquid consistency, hoarseness.

suppurating cyst at the clinic is very similar to abscesses, especially if it is opened and produces pus.However, unlike the classical abscess, cyst median is not capable of resorption and healing.In any case, the tumor requires careful differential diagnosis when it is separated from the similar symptoms on atheroma cysts podpodbrodochnoy zone, dermoid, lymphadenitis.

Tireoglossalnaya child cyst surgically treated, as well as a cyst in the adult patient.Cystectomy is performed under local anesthesia, completely removed the contents of the capsule and the tumor can be resected and a separate part of the hyoid bone.If the cyst abscesses, first drain it, remove the inflammatory symptoms, and the operation is carried out only in a state of remission.Surgical treatment of medial cysts in children is shown with 5 years of age, but sometimes such operations are carried out in an earlier period when the pathological education hinders the process of breathing, eating and cysts larger than 3-5 centimeters.

Median cyst of the neck in adults

In adult patients, including congenital abnormalities of the neck often diagnosed lateral cysts, however, tireoglossalnye tumors represent a threat in terms of the risk of malignancy.Percent transformation and malignant cystic process is very small, however, delayed diagnosis, treatment may carry the risk of neck phlegmon and even cancer.

median neck cyst develops in adults without clinical symptoms for a long time, its latent state can last for decades.Provoke an increase in cysts traumatic factors - blows, bruises and inflammation associated with upper respiratory tract.Cyst increases in size due to accumulation of inflammatory exudate, and often pus.The first prominent clinical sign is considered to be swelling in the middle of the neck area, then there are pain, difficulty swallowing food or liquid, at least - change the tone of voice, shortness of breath, a violation of diction.A serious complication of median neck cyst is considered to compression of the trachea and the degeneration of tumor cells in atypical, malignant.

Tireoglossalnaya cyst treated solely surgically puncturing, conservative methods are not delivering the even delay the process, causing a variety of aggravation.The earlier the surgery to remove the cyst will be carried out, the recovery is faster.Prediction of treatment the median cysts in adult patients generally favorable subject to the timely detection of the tumor and its radical removal.

Diagnostics median neck cyst

How to determine the median cyst?

Tireoglossalnye congenital abnormalities in 75-80% develop without overt clinical signs.Diagnosis median neck cyst may initially be focused on the examination of upper respiratory tract, lymph nodes, in this case, the tumor is diagnosed incidentally, with careful palpation.

Primary monitoring and information confirmed by such methods:

  • ultrasound of the neck, lymph nodes.
  • Roentgen.
  • fistulography (sensing and the use of contrast dye substances).
  • Computed tomography indicated.
  • puncture.

Since the diagnosis of medial neck cysts are quite difficult due to the similarity of symptoms of many diseases Chloe (maxillofacial), from a doctor is required not only theoretical knowledge, but also a great experience.On how true is diagnosed, treatment depends on the choice of methods.

Median cyst should be allocated among such diseases of the parotid region and neck:

  • Congenital dermoid cyst neck.
  • Atheroma.
  • Lymphadenitis.
  • phlegmonous adenitis.
  • Struma language.

Treatment median neck cyst

Treatment of congenital cystic tumors of the neck with the currently performed exclusively by surgery.Median cyst is also subject to cystectomy, regardless of its size and condition.Inflammation of a cyst containing pus, at first treated symptomatically, purulent exudate drained.After neutralization acute process, operation is shown for adult patients.Surgical treatment of medial cyst on her neck, a child may be delayed for several years to achieve a more mature age and ability perensti operation adequately.This is only possible, if the cyst is not increased, and does not prevent the entire functioning of the maxillofacial region.

Median cyst in remission subject to radical removal, regardless of its location - on the hyoid bone or below it.Cystectomy is performed under local anesthesia by layered tissue dissection and resection of the tumor itself, together with the body or part of the hyoid bone.Often tireoglossalnaya cyst combined with a fistula, which is also excised, after filling out the contrast medium to visually identify the fistulous.The complexity of the treatment the median neck cyst is its location close to important organs - the larynx, pharynx, large vessels.Also, difficulties may cause fistula branches, which are not visible during the operation.Incomplete removal of all structural parts of the cyst may trigger a relapse, when the operation has to be repeated after 3-4 months.Therefore, it is important the preliminary examination of the tumor, including fistulogramma using contrast agents, showing all possible fistulous passages.

In carrying out all the diagnostic procedures, correct and accurate operation, recovery occurs very quickly.Furthermore, such operations are "minor surgery" and almost 100% have a favorable prognosis.

Removing the median neck cyst

median neck cyst be removed - this is considered the standard method, excluding any option of conservative therapy or puncture.Removing the median neck cyst performed surgically, by the radical excision of the tumor and the capsule contents.Operations are shown for all patients - adults and children from the age of three.Less cystectomy performed breast kids, for this there are certain indications - threat to life at large cyst size and compression of the trachea, a vast purulent inflammation and the risk of intoxication child's body.

Preference removal, and non-absorbable therapy is associated with the etiology of formation of cysts - all considered congenital anomalies embryogenesis, so the only way to eliminate the consequences of the violation of reduction gill apparatus - an operation.

tireoglossalnoy cyst removal is performed under endotracheal anesthesia or intravenous.Careful dissection of all parts of the cyst and fistula, fistulous and certain areas of the hyoid bone, almost one hundred percent guarantee disease-free recovery.In contrast, removal of lateral cysts, tumors cystectomy median is considered less traumatic and has a favorable prognosis.

operation when the median neck cyst

How is the operation when the median neck cyst:

  1. After a thorough examination of the patient is carried out anesthesia procedure, usually a local anesthetic.
  2. After the introduction of the anesthetic preparation is conducted layered cut cyst localization zone.The cuts extend along the natural folds, so post-operative scars are practically invisible.
  3. walls, husks cyst capsule, the contents of the tumor is drained or washed out depending on the consistency.
  4. If any concomitant fistula and resected portion of the hyoid bone, as the cord fistula is located in this zone.
  5. fistula is removed along with the cyst, its pre-visualized using methylene blue.
  6. Operating wound sutured cosmetic neat seams.

Modern surgical techniques, methods and apparatus allow for the removal of cysts of the middle and low-impact as possible safely.Sutures are applied inside the wound, it can achieve a good cosmetic effect, six months later when the patient is virtually no external scars or post-operative scar on his neck.

operation when the median cyst lasts an average of 30 minutes to one and a half hours in the extreme, complicated cases.The complexity and volume of surgical intervention procedures may depend on the size of the tumor and its contents.Contaminated median cyst removed for longer as it requires draining and careful post-operative revision.If part of the cyst, fistula is not completely excised, recurrence is possible, therefore depends on the care physician favorable outcome of the operation.Even recurrent not considered threatening complication usually repeated operation is shown in 2-4 months after primary and ends at 100% safely.The recovery period lasts no more than a week, after which the patient can return to normal life and perform all the necessary functions, such as household and workers.Within a month are possible swelling at the site of incision, but they disappear without a trace if all the doctor's recommendations.Full recovery depends on the overall health and regenerative properties of the organism.

Prevention median neck cyst

Unfortunately, to say that the development of midline cysts can be prevented, it is not possible.Preventive measures shall be taken for different reasons, but the main - a congenital etiologic factors.Anomalies of development in utero, in principle, considered to be difficult to forecast, these issues are dealt with genetics.Some scholars have put forward version of the inheritance of congenital tumors Chloe (maxillofacial), but this information is controversial and not proven statistically.Prevention median neck cyst may consist of standard guidelines that apply to any disease in principle:

  • Dispensary examinations should be systematic, regular.
  • survey should be subject to all the children, from the moment of birth.
  • Early detection of tumor formation helps take timely measures to cupping process and the planning of surgical intervention.
  • at an early stage diagnosis of cysts of the middle to avoid the bulk operation, which is indicated for the removal of large, inflamed neck tumors.