A neck cyst is a sac-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 cervico-maxillary region. It can develop as an independent pathology for a long time. The cyst is benign in nature, but may degenerate into a malignant one or be complicated by the formation of a fistula or suppuration.
Modern classification divides cysts into lateral and median. However, there is another system in the world that distinguishes the following types of cysts:
- thyroid-hyoid (median);
- gill (lateral);
- timopharyngeal cysts;
- epidermoid (dermoids).
In this article, we will consider two types of cystic formations: median and lateral.
Neck cyst: causes of appearance
The cause of the development of cysts, as a rule, is a congenital pathology. In the last century, a theory appeared that the impetus for this is an anomaly in the development of the first and second gill arches and slits. During the development of the embryo, the fistula does not close completely, which leads to the formation of a gill groove. Later, lateral retention cysts form at this site.
Also, the reasons for the appearance of formations include:
- Rudimentary remnants of the cervical sinus (forming lateral cysts).
- Abnormal development of the second and third branchial cleft (resulting in fistula formation).
- Anomaly in the development of the hypoglossal duct (becomes the cause of the formation of a median cyst).
Congenital cysts of the parotid area and neck have clinical features. The inner wall consists of cells of a cylindrical epithelium with a small number of squamous cells, and the surface of the walls consists of cells of the thyroid gland. Thus, the etiology of cysts is simple - it is a vestige of embryonic ducts and fissures.
A neck cyst can show up during 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 the danger of a cyst
According to statistics, the disease is extremely rare, but it is a very dangerous disease. Late diagnosis of the disease can lead to the death of the patient. The rapid enlargement of the cyst during 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 a median cyst
Characteristic symptoms of a median cyst may be completely absent, and for quite a long time. Often the diseasemanifests itself at the age of 6 years or 13-15. The median cyst of the neck is formed due to the movement along the thyroid-lingual duct of the rudiment of the thyroid gland into 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, it does not have any painful symptoms. Located on the front of the neck. Median cyst occurs in 40% of cases. It is these types of cysts that are prone to suppuration and fistula formation.
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 early pregnancy. Due to a congenital anomaly, the gill furrows do not disappear with development, as a result, a cyst appears in their cavity. The disease is diagnosed immediately after birth. Pathology occurs much more often than the median one, in approximately 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. 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, there is usually no pain. During palpation, a round formation is palpable, mobile and elastic. The cyst is visible when turning the head.
Four types of lateralcysts that differ in their localization:
- Formation located deep in the cervical tissues, on large blood vessels. Quite often fuses with the jugular vein.
- Education located in the clavicular-thoracic region.
- Formation located between the carotid artery and the lateral wall of the larynx.
- Form occupying the area near the carotid artery and the wall of the pharynx.
Symptoms of 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 shade. 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 normal food intake due to pressure on neighboring organs.
Accession of a purulent process in the tumor area is characterized by redness 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 may be located in the sublingual region. With the growth of education, the patient may encounter speech disorders, since the tongue is always in an elevated state. Increasing in size, median cysts cause pain.
Diagnosis of disease
Timely diagnosis of diseases is very important, because if you miss the time, the tumor from benign will degenerate into cancer.
Examination begins with an external examination of the patient and palpation of the cervical area. To diagnose cysts of the median and lateral type, a number of procedures are performed:
- Ultrasound examination of the field of education.
- Probing.
- Puncture with further examination of fluid.
- Fistulography.
- X-ray with contrast injection.
In the absence of infection, the disease is easily confused with lymphadenitis, lymphosarcoma, cavernous hemangioma, neurofibroma, lipoma, vascular aneurysm, abscess, tuberculosis of the lymph nodes. That is why it is so important to carry out 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 type is detected. Early diagnosis and treatment of the disease saves the patient from further complications. When an operation is performed, neck cysts are removed, as a rule, only under general anesthesia. During the intervention, the cyst cavity and all its contents are completely excised, and the resulting wound is sutured. Such manipulations are carried out to eliminate the risk of re-formation of the 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 region of the tongue is carried out either through the oral cavity or through an incision on the side of the neck.
In the presence of an inflammatory process, for example, with an abscess or fistula,Initially, it is required 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 the removal of the inflammatory process (in a few months), the cyst cavity can be completely removed.
Surgical removal of a fistula is a very painstaking process. It requires special care and removal of all fistulous passages, which can be difficult to see and difficult to access. If a neck cyst is found, treatment is prescribed immediately.
Possible Complications
In general, the treatment of lateral and median cysts has a very favorable prognosis, and in case of timely treatment, the risk of recurrence is extremely small. However, complications are sometimes possible. For example, if not all cystic formations or fistulous passages were removed, there is a possibility of re-purulent inflammation.
What is the danger of a cyst for the elderly? The fact that due to age-related characteristics of the body and a weakened immune system, complete excision of the cyst is not carried out. For such patients, an incision is made in the area of the formation to remove all the contents, then the cavity is washed with antiseptic agents. However, this treatment is highly questionable due to the high risk of recurrence of the disease.
Prevention of disease development
As a rule, there are no preventive measures. Genetic predisposition plays an important role in the development of the disease. If the parents had cystic formations, then the only thing they can do is find out the approximate risk of developing the disease in the unborn child. Geneticists deal with similar issues.
If one of the parents had a tumor or cyst in the neck, it is necessary to constantly monitor the baby with a specialist to detect the disease at an early stage. Timely diagnosis and treatment will make the life of the child absolutely normal and he althy. However, the risk of recurrence should never be ruled out, so lifelong regular examinations are necessary.
