The cyst of the neck is a bag-shaped cavity with thin walls and liquid contents inside. Most cystic formations are congenital in nature. The cyst of the neck belongs to a large group of diseases of the facial and cervical-maxillary region. It can develop as an independent pathology for a long time. The cyst is benign, but can degenerate into a malignant or complicated by the formation of fistula or suppuration.
The modern classification divides the cysts into the lateral and median. However, in the world there is another system that distinguishes the following types of cysts:
- thyroid-sublingual (median);
- branchial (lateral);
- thymopharyngeal cysts;
- epidermoid (dermoids).
In this article, we consider two types of cystic formations: median and lateral.
Cyst of the neck: causes
The cause of the development of a cyst, as a rule, is a congenital pathology. In the last century, a theory appeared that the impetus for this is the anomaly in the development of the first and second branchial arches and crevices. During the development of the embryo, the fistula does not close completely, which leads to the formation of gill sulcus. Subsequently, lateral retention cysts form at this site .
Also, the reasons for the appearance of formations include:
- The rudimentary remains of the cervical sinus (form lateral cysts).
- Abnormal development of the second and third branchial fissure (leads to the formation of fistulas).
- An anomaly in the development of the hyoid duct (becomes the cause of the formation of the median cyst).
Congenital cysts of the parotid region and neck have clinical features. The inner wall consists of cylindrical epithelial cells with a small number of squamous cells, and the surface of the walls consists of thyroid cells. Thus, the etiology of cysts is simple - it is the rudiment of embryonic ducts and crevices.
A cyst of the neck can be detected in adolescence. So, for example, the age when the pathology most often manifests itself is 10-15 years. Scientists are inclined to believe that the disease is transmitted from parents to children in a recessive manner.
What is dangerous cyst
According to statistics, the disease is extremely rare, but it belongs to very dangerous diseases. Untimely diagnosis of the disease can lead to the death of the patient. The rapid increase in cysts in adolescence leads to external defects. In addition, a large cyst leads to impaired speech, swallowing reflex, and general malaise. There is a high risk of developing purulent inflammation and degeneration into a cancerous tumor.
Features of the median cyst
The characteristic symptoms of the median cyst may be completely absent, and for a rather long time. Often the disease manifests itself at the age of 6 years or 13-15. The median cyst of the neck is formed due to movement along the thyroid-reed duct the primordium of the thyroid gland in the anterior region of the neck. This pathology develops in the womb.
The median cyst of the neck is a dense and elastic formation, with clear boundaries and a diameter of about 2 centimeters. In the early stages of development does not have any painful symptoms. Located on the front of the neck. The median cyst occurs in 40% of cases. It is these types of cysts that are prone to suppuration and the formation of fistulas.
Features of the lateral cyst
The lateral cyst of the neck differs from the median only in localization. The disease develops in the womb in the early stages of pregnancy. Due to a congenital anomaly, the branchial furrows do not disappear with development, as a result, a cyst appears in their cavity. Diagnose the disease immediately after birth. Pathology occurs much more often than the median, in about 60% of cases.
The lateral cyst of the neck is located on the anterolateral side of the neck. It has a structure both multi-chamber and single-chamber. It is localized in the jugular vein. A large formation compresses blood vessels and nerve endings, as well as neighboring organs, causing pain and discomfort. If the cyst is small in size, pain is usually absent. During palpation, a round formation is palpable, mobile and elastic. The cyst is noticeable when turning the head.
Four types of lateral cysts are known, distinguished by their localization:
- A formation located deep in the neck tissue on large blood vessels. Quite often fused with the jugular vein.
- Education located in the clavicular-thoracic region.
- The formation located between the carotid artery and the lateral wall of the larynx.
- The formation occupying the area near the carotid artery and the wall of the pharynx.
Symptoms of the lateral and median cysts
In the early stages of the disease, or if the cyst is small, there are no symptoms. The skin over the area of the tumor has a normal color. In the event of an injury or any infectious process, the formation begins to grow and compress the nerve endings, which leads to pain. Increasing in size, the cyst begins to bring a lot of inconvenience, including the impossibility of a normal meal due to pressure on neighboring organs.
The addition of a purulent process in the tumor area is characterized by reddening of the skin, while the formation becomes clearly visible to the naked eye. In the future, a fistula is formed at this place.
The median cyst can be located in the sublingual region. With the growth of education, the patient may encounter speech impairment, since the tongue is always in an elevated state. Increasing in size, the median cysts cause pain.
Diagnosis of the disease
Timely diagnosis of diseases is very important, because if you miss the time, then a tumor from benign will degenerate into cancer.
The examination begins with an external examination of the patient and palpation of the cervical zone. To diagnose cysts of the median and lateral type, a number of procedures are performed:
- Ultrasound study of the field of education.
- Sounding.
- Puncture with further study of the fluid.
- Fistulography.
- X-ray with the introduction of a contrast agent.
In the absence of infection, the disease is easily confused with lymphadenitis, lymphosarcoma, cavernous hemangioma, neurofibroma, lipoma, vascular aneurysm, abscess, and lymph node tuberculosis. That is why it is so important to conduct professional diagnostics using the latest equipment.
Treatment of lateral and median cysts
Removal of a neck cyst is performed when a tumor of any size and any kind is detected. Early diagnosis and treatment of the disease saves the patient from further complications. When the operation is performed, the neck cysts are removed, as a rule, only under general anesthesia. During the intervention, the cystic cavity and all its contents are completely excised, and the resulting wound is sutured. Such manipulations are performed to eliminate the risk of re-formation of a cyst.
When excising a lateral cyst, some difficulties may arise due to the proximity of the tumor to the nerve endings. Removal of education in the tongue is carried out either through the oral cavity, or through an incision from the neck.
In the presence of an inflammatory process, for example, with an abscess or fistula, initially it is necessary to get rid of the accumulation of pus. The cyst itself is not removed - the patient is prescribed anti-inflammatory therapy. If necessary, and after removal of the inflammatory process (after several months), the cyst cavity can be completely removed.
Prompt removal of the fistula is a very painstaking process. It requires special care and removal of all fistulous passages, which can be difficult to see and inaccessible. If a neck cyst is detected, treatment is prescribed immediately.
Possible complications
In general, treatment of lateral and median cysts has a very favorable prognosis, and in case of timely treatment, the risk of relapse is extremely small. However, complications are sometimes possible. For example, if not all cystic formations or fistulous passages were removed, there is a likelihood of repeated purulent inflammation.
What is the danger of a cyst for the elderly? Due to the age-related characteristics of the body and a weakened immune system, complete excision of the cyst is not performed. Such patients make an incision in the area of education to remove all contents, then the cavity is washed with antiseptic agents. However, this treatment is very doubtful because of the high risk of re-development of the disease.
Disease Prevention
As a rule, preventive measures do not exist. An important role in the development of the disease is played by a genetic predisposition. If cystic formations occurred in parents, then the only thing they can do is to find out the approximate risk of developing the disease in the unborn child. Geneticists deal with such issues.
In the event that one of the parents had a tumor or cyst in the neck, constant monitoring of the baby by a specialist is necessary to identify the disease at an early stage. Timely diagnosis and treatment will make the child's life absolutely normal and healthy. At the same time, the risk of relapse should never be excluded, therefore, a lifelong regular examination is necessary.