Wrodzone anomalie szyi u dzieci: torbiele i przetoki szyi

Teresa Ryczer, *Lidia Zawadzka-Głos, Katarzyna Sobczyk

Summary
Introduction. Branchial cleft cysts, thyroglossal duct cysts and branchial cleft fistulas are congenital anomalies. Differential diagnosis consist of lesions that have congenital, inflammatory or neoplastic etiology.
Material and methods. Retrospective analysis of patients with neck masses that have been hospitalized in the Department of Pediatric Otorhinolaryngology of Medical University of Warsaw in years 2011 to 2013 have been done. The group of 47 children with initial diagnosis of branchial cleft cyst, thyroglossal duct cyst and branchial cleft fistula was selected. Demographic characteristics, localization of the lesion, type of diagnostic imaging, antibiotic therapy and management was evaluated.
Results. There were 47 patients (M:27, F:20). Final diagnosis confirmed initial diagnosis in 39 cases: thyroglossal duct cyst n = 17, branchial cleft cyst n = 13, branchial cleft fistula n = 9. Other results of histopathological examination stated: atheroma, lymphangioma cavernosum, epithelioma calcificans Mahlerbe. Thyroglossal duct cyst was more frequent in boys (p < 0.05). Branchial cleft cyst and branchial cleft fistula were more often right-sided (p < 0.01). Branchial cleft cysts were more frequent in patients over 15 years old (p < 0.01). Diagnostic imaging tests performed were ultrasonography (65%), computed tomography (19%), thyroid scyntygraphy (14%).
Conclusions. The most frequent congenital lesion was thyroglossal duct cyst and it was more frequent in males. Branchial cleft cysts manifested more frequently in children over 15 years old. Branchial cleft cyst and fistulas were more often right-sided. Clinical features of thyroglossal duct cyst or branchial cleft cyst may imitate neck masses of different etiology. Ultrasonography should be first-line imaging in a patient with neck mass. A patient with branchial cleft cyst, thyroglossal duct cyst or branchial cleft fistula should undergo surgical treatment.

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