Neck cyst median and lateral: treatment. What is dangerous cyst?

The cyst of the neck is a cavity of a bag-shaped form with thin walls and liquid contents inside. Most cystic formations are congenital in nature. The neck cyst belongs to a large group of diseases of the facial and cervico-maxillary. It can develop as an independent pathology for a long time. The cyst is benign in nature, but can degenerate into a malignant one or be complicated by the formation of a fistula or suppuration.

Modern classification divides cysts into lateral and median cysts. However, there is another system in the world that distinguishes the following types of cysts:

• Thyroid-sublingual (median);
• Gill (lateral);
• Thymopharyngeal cysts;
• Epidermoid (dermoid).

In this article we consider two types of cystic formations: median and lateral.

Neck cyst: causes of appearance

The cause of cyst development, as a rule, is congenital pathology. In the last century, a theory appeared that the anomaly of the development of the first and second branchial arches and cracks serves as an impetus to this. During the development of the embryo, the fistula is not completely closed, which leads to the formation of a gill furrow. Later on, lateral retention cysts are formed at this site .

Also, the reasons for the appearance of formations are:

• Rudimentary remains of the sinus (form the lateral cysts).
• Abnormal development of the second and third gill slit (leads to fistula formation).
• Anomaly of development of the sublingual duct (causes the formation of the middle cyst).

Congenital cysts of the parotid zone and neck have clinical features. The inner wall consists of cells of cylindrical epithelium with a small number of cells flat, and the wall surface consists of cells of the thyroid gland. Thus, the etiology of the cysts is simple - it is a rudiment of embryonic ducts and cracks.

The neck cyst can show up during adolescence. So, for example, the age when the pathology itself most often manifests, is 10-15 years. Scientists are inclined to believe that the disease is transmitted from parents to children by a recessive type.

Than the cyst is dangerous

According to statistics, the disease is extremely rare, but it refers to very dangerous diseases. Untimely diagnosis of the disease can lead to the death of the patient. A rapid increase in cyst in adolescence leads to external defects. In addition, a large cyst leads to speech disorders, a swallowing reflex, a general malaise. There is a high risk of purulent inflammation and degeneration into a cancerous tumor.

Features of the middle cyst

Characteristic symptoms with a middle cyst may be completely absent, and quite a long time. Often, the disease manifests 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-tongue duct of the rudiment of the thyroid gland into the anterior region of the neck. This pathology develops in the womb of the mother.

The median cyst of the neck is dense and elastic, with clear boundaries and a diameter of about 2 centimeters. In the early stages of development, it does not have any painful symptoms. It is located on the front side of the neck. The 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 by localization. The disease develops in the womb in the early stages of pregnancy. Because of a congenital anomaly, the gill furrows do not disappear with development, as a result, a cyst appears in their cavity. Diagnose the disease immediately after birth. There is a pathology much more often median, approximately in 60% of cases.

The lateral cyst of the neck is located on the anterolateral side of the neck. Has a structure both multi-chamber, and one-chamber. It is localized in the jugular vein. The formation of large size compresses blood vessels and nerve endings, as well as neighboring organs, causing painful sensations and discomfort. If the cyst is small, pain is usually absent. During palpation, a circular formation, mobile and elastic, is palpated. The cyst is noticeable when the head is turned.

There are four types of lateral cysts, differing in their localization:

• Education, located deep in the neck tissue, on large blood vessels. Quite often it fuses with the jugular vein.
• Education, located in the clavicle-thoracic region.
• Education, located between the carotid artery and the lateral wall of the larynx.
• The formation occupying the area near the carotid artery and the pharyngeal wall.

Symptoms of lateral and middle cysts

In the early stages of the disease, or if the cyst is small, no symptoms are present. The skin above the tumor region has a normal shade. In the case of trauma or any infectious process, the formation begins to grow and squeeze the nerve endings, which leads to painful sensations. Increasing in size, the cyst begins to bring a lot of discomfort, including the inability to eat normally due to pressure on neighboring organs.

Attachment of purulent process in the tumor area is characterized by reddening of the skin, while formation becomes clearly visible to the naked eye. In the future, a fistula is formed at this site.

The median cyst may be located in the hyoid area. With the growth of education, the patient may encounter speech disorders, since the language is always in a raised state. Increasing in size, the middle cysts cause pain.

Diagnosis of the disease

Timely diagnosis of diseases is very important, because if you miss the time, the tumor from benign will turn into cancerous.

The examination begins with an external examination of the patient and palpation of the cervical region. To diagnose cysts of the median and lateral types, a number of procedures are performed:

• Ultrasound examination of the field of education.
• Sounding.
• Puncture with further study of fluid.
• Fistulography.
• Radiography with the introduction of contrast medium.

In the absence of infection, the disease is easily confused with lymphadenitis, lymphosarcoma, cavernous hemangioma, neurofibroma, lipoma, vascular aneurysm, abscess, tuberculosis of lymph nodes. That is why it is so important to conduct professional diagnosis using the latest equipment.

Treatment of the lateral and median cysts

Removal of the cyst of the neck is performed when a tumor is detected of any size and any kind. Early diagnosis and treatment of the disease relieves the patient of further complications. When the operation is performed, the cysts of the neck are removed, as a rule, only under general anesthesia. During the intervention, the cyst cavity and all its contents are completely excised, and the wound formed is sutured. Such manipulations are carried out to exclude the risk of re-education of the cyst.

When excising the lateral cyst, some difficulties may arise due to the proximity of the tumor to the nerve endings. Removal of education in the area of the tongue is carried out either through the oral cavity, or through a cut from the side of the neck.

In the presence of an inflammatory process, for example, with an abscess or fistula, it is initially necessary 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 removal of the inflammatory process (after a few months), the cyst cavity can be completely removed.

Operative removal of the 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. In the event that a cyst of the neck is found, treatment is prescribed immediately.

Possible complications

In general, treatment of the lateral and middle cysts has a very favorable prognosis, and in the 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 have been removed, there is a possibility of repeated purulent inflammation.

What is dangerous cyst for the elderly? The fact that due to age characteristics of the body and a weakened immune system complete excision of the cyst is not carried out. Such patients are incised in the area of education to remove all the contents, then the cavity is washed with antiseptic agents. However, this treatment is highly doubtful because of the high risk of recurrent disease.

Prevention of the development of the disease

As a rule, preventive measures do not exist. In the development of the disease, an important role is played by genetic predisposition. If the cystic formations met at the parents, then the only thing they can do is find out the approximate risk of the future child's development of the disease. Similar questions are dealt with by geneticists.

In the event that one of the parents had a tumor or cyst in the neck, it is necessary to constantly monitor the baby from a specialist to identify the disease at an early stage. Timely diagnosis and treatment will make the child's life completely normal and healthy. In this case, one should never exclude the risk of recurrence, therefore a lifelong regular examination is necessary.