Lateral cervical cyst (congenital) is a neoplasm of benign character and rare in 002% of patients with this or that neck tumor. The mechanism of the origin of the disease has been studied for two centuries already, but the etiology is still unclear. All available versions are associated with violations during embryonic development, that is, with various defects and disorders in the development of the baby in the womb.
The cyst is formed in the early stages of pregnancy and in 90% of cases it is impossible to single out the symptoms of the disease, which makes it practically impossible for a clear differentiation of this disease relative to other cervical diseases.
In most cases of the disease, this cyst is not dangerous, but in the presence of a purulent, inflammatory process, in a latent form, the cyst can grow into a malignant neoplasm.
Causes of lateral cervical cyst
Another name for the cyst is branhyogenic, which explains the approximate etiology of the disease ("Branchia" means "gills"). Approximately at the fourth week of embryonic development, the child develops a gill apparatus that has five gill pockets (specialized cavities), gill slits and arcs, with which they connect (arcusbranchialis). The tissue cells of the apparatus subsequently form the maxillofacial region of the child (CHO) as it moves along the anterolateral plane. In violation of development, the arc is not completely obliterated, which entails the appearance of cavities and holes. The result is the formation of a fistula (fistula) and a cyst consisting of ectodermal tissue; the fistula is formed from the endodermal tissue (like the pharyngeal pocket tissue).
Types of branhyogenic disorders during embryogenesis:
The most common reason for the formation of this cyst is the presence of rudimentary remains of the second pocket, the function of which is to form the tonsils. In two thirds of cases, this cyst is surrounded by a fistula, its outer opening has the property of appearing at any site along the edge of the nipple, and the fistula is localized along the carotid artery, and in some cases crosses it. In comparison with atheroma or hygroma, this cyst is quite deep, and it is detected in children older than 10 years or adults. The lateral fistula can be diagnosed earlier - from the period of the newborn to the age of seven. However, at this age it can be identified, if it is complete and has two holes; one of them is localized in the side of the pharynx, while the other is located in the region of the clavicle-mastoid muscle (on the site Musculussternocleidomastoideus). In general, the causes of the lateral cyst explain how it is formed: the inner side of the cyst is lined with multilayer epithelium or the cylindrical cells, lymphoid tissue (the starting material for the formation of branchial arches and pockets).
Symptomatology of the lateral cervical cyst
Symptomatic cysts do not have their own specifics and on the whole are similar to those of the middle benign cervical tumor. But, if we compare the symptoms of this cyst with the manifestations of the thyoglossal cyst, the gill cyst is more distinctly revealed and the gill area is located between the second and third fasciae on the side, touching the frontal zone of the sternocleidomastoid muscle.
Symptomatic of the lateral cyst of the neck begins to show up after the inflammation or injury and is of the following character:
Branhyogenic cervical cyst in a child
The gill neural cyst is mostly diagnosed in children older than seven years, since anomalies in the cervical region are rare in nature and are found closer to the age corresponding to the sexual development of a person. If the patient is a child under seven years of age, a newborn, this cyst is most likely to be in a latent form and will not manifest itself until the provoking factor appears, which is an infectious process or trauma. There is a version about the interdependence of the appearance of the lateral cyst and hormonal changes in the body. Data on the statistics for this disease are few and can not be used to reliably assess the situation, but surgeons say that the majority of those affected are boys.
Respiratory diseases are often the precursors of the occurrence of cysts in children, influenza does not lead to the manifestation of the disease so often. The tumor is closely connected with the lymphatic ways, which leads to easy penetration of microorganisms into the tumor cavity. In the main process accompanying suppuration.
An increase in the cyst carries the same danger as the complications that arise after it - phlegmon and abscess. In 25% of patients who had consulted a doctor with a cervical abscess, the gill cyst of the neck was diagnosed.
Treatment of the lateral cyst is extremely rapid, excluding the stage of exacerbation. If a purulent process is observed, anti-inflammatory therapy is prescribed, puncture, then, as the signs of cyst inflammation fade away, it is promptly removed. Usually, children over three years of age are operated, but in the event that the cyst is a threat to the baby's life, the operation can be performed earlier.
Treatment of the branhyogenic cyst of the neck
The only method used in resolving the situation is an operation that is performed both outpatiently and in a hospital, which depends on the following factors:
During excision, the lateral cervical cyst is prepared for fistulous tendons, cords and partially hyoid bone. Sometimes tonsileectomy is indicated. If the cyst is removed completely, recovery comes, relapse is possible with the proliferation of the cyst epithelium in tissues that are near or incomplete removal of fistula passages.
Inflamed cysts with pus formed are first treated conservatively, using antibacterial therapy. At the onset of the remission phase, the cyst is removed promptly.