The term “Thornwald’s cyst” refers to a congenital neoplasm that is localized on the posterior wall of the nasopharynx. At the first symptoms of the disease, you must consult a doctor. This is due to the fact that the Tornwald cyst (a photo of a tumor image after computed tomography is presented below) can provoke the development of all kinds of complications that pose a health hazard. Currently, the treatment of the disease involves the use of surgical techniques. Conducting drug therapy is advisable only at the postoperative stage. Another name for the pathology is a nasopharyngeal bag.
Development mechanism
The formation of a neoplasm occurs even in the womb. Normally, the fetus develops a nasopharyngeal bag from the 5th to the 10th week. This is a paired pocket, which is divided into segments. It is localized on both sides of the chord. During further intrauterine development, the formation of the thyroid gland, thymus, and middle ear cavity occurs from this pocket.
Normally, this formation is reduced at 10 weeks. But under the influence of various adverse factors, sections of the pharyngeal endoderm and notochord stick together (it is from them that the bag develops). The latter, as the fetus grows, rises to the level at which the skull will be. At the same time, he drags part of the pharyngeal mucosa with him. As a result, a Thornwald cyst is formed. In other words, it is a cavity that is lined with a mucous membrane.
Causes
In the nasopharynx, the Thornwald cyst is formed against the background of abnormal development of the endoderm. Currently, the etiology of the disease is not fully understood. But it is proved that the disease is congenital in nature.
In addition, today it is known that the following conditions are provoking factors:
- Hereditary predisposition. In the presence of a cyst in the next of kin, the probability of its development in the offspring is 50%.
- Genetic mutations. Most often, a neoplasm is diagnosed in persons who are in a closely related marriage. In addition, the first pregnancy after 35 years is a risk factor.
- Hypothermia of the body during the period of gestation.
- Stay under ionizing rays during pregnancy.
- Intoxication of the body with salts of heavy metals, benzene vapors and nitrates.
- The use during pregnancy of alcohol-containing drinks, drugs.
- Tobacco during gestation.
- Living in adverse environmental conditions.
- Taking some medications, especially uncontrolled.
Thus, it is impossible to get rid only of a hereditary predisposition. The woman is able to exclude other risk factors during pregnancy, significantly reducing the likelihood of developing Thornwald cysts.
Symptoms
The nasopharyngeal bag alone does not cause any discomfort. In most cases, it remains unnoticed for a long time and is detected randomly during an examination prescribed for another reason.
The first clinical manifestations occur when an infection is attached or when there is a violation of the outflow of mucus from the cavity. In such cases, an inflammatory process develops.
In this situation, the following symptoms of Tornwald cysts occur:
- Difficult nasal breathing.
- High body temperature.
- Pronounced headaches. They are localized in the parietal zone. Pain after taking analgesics is weakened only for a short period of time.
- Frequent episodes of pharyngitis, otitis media and sinusitis. In the future, these pathologies become chronic.
- When sneezing, coughing and even swallowing food, a person experiences intense pain in the throat and nose.
- Bad breath. However, there are no problems in the gastrointestinal tract.
- Gnawiness in the voice.
- Frequent episodes of exacerbation of existing pathologies of the nasopharynx of a chronic nature.
- Congestion in ears, hearing impairment. This is due to edema of the inflamed tissues, which narrow the lumen of the Eustachian tube.
- Bad taste in the mouth. It occurs as a result of ingestion of purulent contents from a nasopharyngeal bag into the nasopharynx.
Regardless of the severity of symptoms, treatment of Thornwald cysts cannot be delayed. Only with timely medical attention can the development of complications be avoided.
Diagnostics
If alarming symptoms occur, you must make an appointment with an otorhinolaryngologist. The doctor will conduct an initial diagnosis and refer the patient to a comprehensive examination, based on the results of which he will choose the treatment tactics.
To confirm the Thornwald cyst, you must go through:
- Pharyngoscopy.
- Computed tomography.
- Rhinoscopy
- Otoscopy.
- Rhinoendoscopy.
In addition, the patient must donate blood for a general analysis. Clinically important indicators are the number of leukocytes and the erythrocyte sedimentation rate.
In some cases, a biopsy is indicated. It is carried out as part of the differential diagnosis of tumors with tumors of both benign and malignant nature.
Treatment
Based on the research results, the doctor makes a choice of surgical procedure. It is important to know that conservative treatment of Thornwald cysts is inappropriate, since it does not lead to positive results. It is also impossible to get rid of the neoplasm using folk methods.
Cyst removal is currently carried out in the following ways:
- Traditional. The method involves excision of the neoplasm with a scalpel. After the operation, normal nasal breathing is immediately restored and unpleasant symptoms disappear. The removed tissue is then sent for histological examination.
- Endoscopic. Intervention is carried out using a device equipped with a backlight and a small video camera. The doctor monitors all the manipulations by looking at the images on the monitor.
- Laser. Allows for complete removal of the Thornwald cyst. There is no damage to healthy nearby tissues.
As a rule, during surgery, complications do not occur. Full recovery occurs in 8 out of 10 patients.
Postoperative period
A person can begin to carry out their daily activities immediately after surgery. Special care for the nasal cavity is not required. Immediately after removal, the doctor prescribes the patient to take broad-spectrum antibiotics. In addition, after healing, it is necessary to undergo a CT scan again to confirm the success of surgical treatment and to exclude the presence of complications.
Effects
Ignoring the disease is unacceptable. In the absence of treatment, the following pathological conditions occur:
- Frequent episodes of sinusitis.
- Constant snoring.
- Curvature of the nasal septum.
- Inflammation of the middle ear.
- Tonsillitis.
- Gingivitis.
- Breakthrough cysts. As a result, purulent contents enter the larynx, due to which pharyngitis, laryngitis, bronchitis and aspiration pneumonia develop.
- Severe headaches. At the same time, improvements do not occur even after taking analgesics.
Thus, it is necessary to consult a doctor when the first alarming signs appear.
Prevention of Complications
There are no measures to prevent a pathology of a hereditary nature. However, each patient is able to prevent the development of complications.
To do this, you must:
- Regularly expose the body to moderate physical exertion.
- Twice a year to be examined by an otorhinolaryngologist.
- If nasal breathing is difficult, consult a doctor immediately.
- Exclude smoking.
- Do not drink alcohol.
- Avoid hypothermia.
- Avoid injury.
- Timely treat chronic diseases.
- Monitor the health of both your and your baby during pregnancy.
- Avoid getting into stressful situations.
After a successful operation, it is necessary to observe the principles of a healthy lifestyle and strengthen the body's defenses.
Finally
Thornwald's cyst is a congenital neoplasm of the nasopharynx. For a long time the disease is asymptomatic. The first clinical manifestations occur when an infection is attached. If there are alarming signs, you should contact your ENT specialist as soon as possible. The doctor will conduct diagnostic measures and, based on their results, determine the tactics of surgical intervention. The prognosis for timely contact with a specialist is favorable.