Lateral neck cyst: causes, symptoms. How to treat

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:

  • Cyst;

  • Complete fistula with two exits;

  • Incomplete fistula having one exit;

  • Fistula in combination with a branhyogenic cyst.

  • 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:

  • The cyst is diagnosed as an almost invisible compaction in the region of the carotid artery (the so-called "sleep triangle");

  • When performing palpation, the patient feels soft, moving, but not causing a painful neoplasm;

  • The gill cyst of the neck has the property of increasing in size with the course of the patient's respiratory disease (influenza, acute respiratory infections, acute respiratory infections);

  • The tumor grows and sometimes reaches a dozen centimeters in diameter, it can be seen with the naked eye;

  • In the inflammatory process of cysts, the cervical lymph node adjacent to it can increase;

  • The larynx shifts in view of the increase in the size of the cyst;

  • The cyst has the property of acting on the vascular-neural bundle, which leads to the onset of pain syndrome;

  • Inflammation of the cyst is accompanied by a purulent process and an abscess;

  • Intensive inflammation of this cyst is combined with phlegmon and concomitant symptoms: an increase in body temperature, immobilization of the neck, poisoning of the body, trauma to the sternocleidomastoid muscle;

  • In the case of a purulent process, there is a tendency to rupture the walls of the cyst and isolate the contents from the fistula;

  • The cyst can lead to digestive disorders through the complication of the swallowing process and lead to a feeling of discomfort in the esophagus (the phenomenon of dysphagia);

  • In view of the increase in the cyst, diction and respiratory function are impaired;

  • The lateral cyst in the larynx provokes a stridor - a characteristic sound of the whistle during breathing.

  • 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:

  • Diagnosis period of the lateral cyst. It is believed that the faster the cyst can be diagnosed, the better the treatment will be.

  • Age of the patient. It is harder to operate small children, but it is necessary in case of serious violations of the function of breathing and poisoning the body.

  • The size of the cyst. The operation is made if the size of the cyst exceeds the centimeter in diameter.

  • Location of the lateral cyst. With a direct arrangement near the nerves and vessels, the operation is very complicated.

  • Type of cyst is a purulent process, a cyst with inflammation.

  • Complications in the course of cyst formation: in the presence of abscess and phlegmon, anti-inflammatory therapy is necessary.

  • Type of fistula, completely diagnosed already during the operation. Incomplete or complete fistula difficult to treat, because the fistulas are adjacent to the hyoid bone, trunk vessels and pharynx.

  • 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.