Tornwaldt cyst

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Tornwaldt cyst (also known as Tornwaldt's cyst, nasopharyngeal cyst, or pharyngeal bursa cyst) is a benign cyst that occurs in the nasopharynx, the upper part of the throat behind the nose. It is named after the German pathologist Gustav Ludwig Tornwaldt, who first described it in the 19th century.

Anatomy and Pathophysiology

The nasopharynx is a part of the pharynx that lies above the soft palate and behind the nasal cavities. A Tornwaldt cyst arises from the pharyngeal bursa, a midline recess in the nasopharyngeal mucosa. This cyst forms due to the persistence and subsequent cystic degeneration of the notochordal remnant in the nasopharynx.

Clinical Presentation

Tornwaldt cysts are often asymptomatic and are usually discovered incidentally during imaging studies for other conditions. When symptoms do occur, they may include:

• Nasal obstruction
• Postnasal drip
• Halitosis (bad breath)
• Otitis media (middle ear infection) due to Eustachian tube dysfunction
• Headache

Diagnosis

The diagnosis of a Tornwaldt cyst is typically made through imaging studies such as:

• Magnetic Resonance Imaging (MRI)
• Computed Tomography (CT) scan

These imaging modalities help in identifying the cyst's location, size, and its relationship with surrounding structures.

Treatment

Asymptomatic Tornwaldt cysts generally do not require treatment. Symptomatic cysts may be managed through:

• Surgical excision: Removal of the cyst via endoscopic surgery
• Marsupialization: Creating an opening in the cyst to allow drainage

Prognosis

The prognosis for individuals with a Tornwaldt cyst is excellent, especially when the cyst is asymptomatic or successfully treated. Recurrence after surgical treatment is rare.

See Also

• Nasopharynx
• Pharynx
• Cyst
• Otitis media
• Nasal obstruction