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[The pathogenesis of the nasopharyngeal bursa (Tornwaldt's disease) (author's transl)]
Abstract:
The pharyngeal recess, first described in 1842 by Mayer, is a cavity in the middle of the nasopharynx, just between the nasal septum and the ventral tuberculum atlantis. It was assumed to be an excavation of the pharyngeal mucous membrane often persistantly fixed to the embryonic spine (Chorda dorsalis). It might be therefore, looked upon as a malformation. The recess is always stuffed with mucous membrane of the pharyngeal tract and ends next to the adenoids. It might pass into the occipital bone as an epithelialized cleft surrounded by connective tissue. Cystic transformation of the recess was first described by Tornwaldt in 1885, causing discomfort in the epipharyngeal and adjacent areas, and was named Tornwaldt's disease. The clinical data of 12 patients with pharyngeal cysts are presented. The conclusion is made, that we have evident lack of knowledge between the rare clinical manifestation of the pharyngeal recess only in adults on the one hand and the almost constant presence of the pharyngeal recess in human embryos on the other. It is therefore assumed, that frequent inflammatory discharge of the nasopharynx during life initiates the development of the nasopharyngeal cyst and not vice versa.
Insights
The pharyngeal recess, a nasopharyngeal cavity, may develop into cysts in adults due to inflammation, not from embryonic remnants. This study explores the link between inflammation and pharyngeal cyst development.
Area of Science:
- Anatomy
- Pathology
- Embryology
Background:
- The pharyngeal recess is a nasopharyngeal cavity described by Mayer in 1842.
- It was historically considered a malformation due to its connection to embryonic structures.
- Cystic transformation, known as Tornwaldt's disease, was described by Tornwaldt in 1885.
Purpose of the Study:
- To investigate the relationship between the pharyngeal recess and nasopharyngeal cysts.
- To clarify the etiology of pharyngeal cysts in adults.
- To address the lack of knowledge regarding the pharyngeal recess's clinical manifestation in adults versus its presence in embryos.
Main Methods:
- Review of clinical data from 12 patients with pharyngeal cysts.
- Comparison of the pharyngeal recess's presence in adults and human embryos.
- Analysis of potential etiological factors for cyst development.
Main Results:
- Pharyngeal cysts were observed in 12 adult patients.
- A discrepancy exists between the rare clinical manifestation of the pharyngeal recess in adults and its common presence in embryos.
- Inflammatory discharge in the nasopharynx is hypothesized as the initiator of cyst development.
Conclusions:
- The development of nasopharyngeal cysts in adults is likely initiated by recurrent nasopharyngeal inflammation.
- The pharyngeal recess itself may not be a malformation but a structure whose inflammation leads to cyst formation.
- Further research is needed to fully understand the pathogenesis of pharyngeal cysts.