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© Borgis - New Medicine 4/2014, s. 126-128
Monika Jabłońska-Jesionowska, *Lidia Zawadzka-Głos
Clinical analysis of patients with neck cysts in Department of Pediatric Otolaryngology Medical University of Warsaw in years 2011-2014
Department of Pediatric Otorhinolaryngology, Medical University of Warsaw, Poland
Head of Department: Lidia Zawadzka-Głos, MD, PhD
Summary
Introduction. On the neck in children often appears to variety masses. Most of them are benign lesions due to inflammatory processes. There are also malignancy changes, but most frequently occurs congenital cysts.
Aim. The aim of this study was to analyze clinical data of 42 children admitted to the ENT Pediatric Department of Medical University of Warsaw with initial diagnosis of cysts of the neck.
Material and methods. The records of 42 patients were analyzed according to the age, gender, location of changes, the type of treatment and long-term results.
Results. Among a group of 42 children in 26 changes were localized in the midline of the neck, in 16 in the lateral regions of the neck. In 26 children with changes in the midline in 22 cases the congenital malformation were found. Among the 15 children with changes localized in the lateral regions of the neck in 14 cases congenital defects were found. Most frequent congenital anomalies of midline was thyroglossal duct cyst and in laterocervical region cysts of second branchial apparatus. All children underwent surgery in the ENT Department.
Conclusions. Cystic changes of the neck are the most common congenital malformations. Changes located in the midline most often occur in the first decade of life, changes in the lateral regions of the neck over the first decade of life. Complete surgical removal of the cysts prevents recurrence. Each removed mass requires histopathological examination.
INTRODUCTION
On the neck in children often appears variety masses. Most of them are benign lesions due to inflammatory processes. Lymphadenopathy also occurs in the course of malignancy. In addition to the enlargement of lymph nodes in the neck, there are also solid and cystic changes. All neck masses require differentiation and exclusion of neoplasmatic processes. Most of the cystic changes are congenital origin. They are formed within the first month of intrauterine life, but the clinically manifest themselves in different groups of children according to the age, mostly in the course of infections of the upper respiratory tract. They are difficult to diagnose, do not have the specific signs in the imaging studies, appear at different ages, and are often becomes inflamed. The location on the neck is the most characteristic feature, which suggests the diagnosis. The midline neck masses derived from the gastrointestinal thyroglossal tract, in laterocervical regions changes come from the branchial apparatus.
AIM
The aim of this study was to analyze clinical data of 42 children admitted to the ENT Pediatric Department of Medical University of Warsaw with initial diagnosis of cysts of the neck.
MATERIAL AND METHODS
In the period 2011-2014 to the ENT Pediatric Department of Medical University of Warsaw 42 children was admitted suspected of cysts of the neck. The records of patients were analyzed according to the age, gender, location of changes, the type of treatment and long-term results. 40 children underwent surgery to remove changes: 38 in the ENT ward, 2 in pediatric surgery ward. The final diagnosis was based on histopathology.
RESULTS
Among a group of 42 children admitted to our ENT Department suspected of the neck cysts in 26 children (61.9%) changes were localized in the midline of the neck, in 16 (38%) in the lateral regions of the neck. In 26 children with changes in the midline in 22 (84.6%) cases the congenital malformation were found: 18 thyreoglossal duct cysts and 4 dermoid cysts. In the next 4 cases after surgery atheroma in histopathology was diagnosed. Among the 15 children with changes localized in the lateral regions of the neck in 14 (87.5%) cases congenital defects were found: 10 cysts of the branchial apparatus, 2 lymphangiomas, 1 laryngocele, 1 pulmonary hernia of the cervical fascia, 1 atheroma and 1 post-traumatic hematoma were found. Distribution of changes shows table 1 and 2. Most frequent congenital anomalies of midline was thyroglossal duct cyst, occurred in 12 girls and 6 boys. The children were between 1 and 6 year old. Dermoid cysts were recognized after completely removal of the changes, based on histopathology in 4 boys aged between 1 to 3. Before surgery the ultrasound image of the neck in all children was done. We also determined the location of the thyroid lobe. All children underwent surgery in the ENT Department. Excision of the cyst with tract penetrating the hyoid bone and the central part of bone does not give a recurrence of the disease. In 2 cases the core of the hyoid bone was removed during reoperation because of recurrence. In one child in spite of the removal of the hyoid bone there was a recurrence of cyst, reoperation showed tract penetrating the base of the tongue.
Table 1. Distribution of the laterocervical malformations.
Type of malformationNumber
Cystis branchiogenes10
Lymphangioma cavernosum2
Laryngocele1
Pulmonary hernia of the cervical fascia1
Table 2. Distribution of the midline malformations.
Type of malformationNumber
Thyreoglossal duct cysts18
Dermoid cysts4

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otrzymano: 2014-11-04
zaakceptowano do druku: 2014-11-28

Adres do korespondencji:
*Lidia Zawadzka-Głos
Department of Pediatric Otolaryngology Medical University of Warsaw
24 Marszałkowska Str., 00-576 Warsaw, Poland
tel./fax: +48 (22) 628-05-84
e-mail: laryngologia@litewska.edu.pl

New Medicine 4/2014
Strona internetowa czasopisma New Medicine