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Main features and treatments of cervical cysts in children from a single-center experience
Nian Sun1, Wei Pang1, Xuexi Zhang1
1Department of Otolaryngology-Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56# Nanlishi Road, Xicheng District, Beijing, 100045, China.
Insights
Pediatric cervical cysts present as neck masses. Comprehensive evaluation and surgical removal are key for diagnosis and treatment, though complications like dysphagia and recurrence can occur, particularly with thyroglossal duct cysts and lymphatic malformations.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Medical Imaging
Background:
- Cervical cysts are common in children, often presenting as painless neck masses.
- Early diagnosis and effective management are crucial for pediatric patients.
Purpose of the Study:
- To summarize clinical features of pediatric cervical cysts.
- To discuss diagnostic and treatment approaches and associated complications.
- To improve the diagnosis and treatment of pediatric cervical cysts.
Main Methods:
- Retrospective analysis of pediatric cervical cyst cases from January 2018 to December 2023.
- Evaluation of clinical presentation, medical imaging (ultrasound, MRI), surgical approaches, complications, and recurrence.
- Histopathological analysis of five main cyst categories: thyroglossal duct cyst (TGDC), branchial cleft cyst (BCC), dermoid cyst (DC), lymphatic malformation (LM), and bronchogenic cyst (BC).
Main Results:
- Painless neck masses were the primary symptom, sometimes with sleep apnea, stridor, odynophagia, or hoarse voice.
- Median cyst size was 1.7x1.0x1.6 cm; median operation duration was 55 minutes.
- Common complications included dysphagia and inflammatory wound swelling; 7 patients experienced recurrence, notably those with TGDC and LM.
Conclusions:
- Comprehensive evaluation (history, physical exam, ultrasound, MRI) is essential for accurate diagnosis.
- Surgical removal is the primary treatment modality for pediatric cervical cysts.
- Post-surgical complications often involve vascular or nerve injury; recurrence is linked to TGDC and LM.
Background:
The cervical cysts is one of the most common children ailments an ENT surgeon encountered, which often begins with painless masses in the neck. The present study summarizes main clinical features of various types of children cervical cysts and discusses the possible approaches and associated complications, with an aim to improve the diagnosis and treatment of this pediatric disease.
Methods:
We retrospectively analyzed the clinical data of patients admitted with cervical cyst to Beijing Children's Hospital, Capital Medical University from January 2018 to December 2023. Analysis focused on the clinical presentation, medical imaging, surgical approach, treatment-related complications as well as disease recurrence.
Results:
The main self-reported symptom at first admission was painless masses at neck and submandibular space accompanied by sleep apnea, laryngeal stridor, odynophagia or hoarse voice. Three hundred and eighty-four patients received cervical ultrasound examination, whereas 92 patients were subjected to cervical MRI. The median of cysts size recorded by medical imaging was 1.7 cm*1.0 cm*1.6 cm. The median operation duration was 55 min. Histology of removed cysts indicated five main pathological categories including thyroglossal duct cyst (TGDC), branchial cleft cyst (BCC), dermoid cyst (DC), lymphatic malformation (LM) and bronchogenic cyst (BC). The most frequent postsurgical complication was dysphagia and inflammatory wound swelling. Seven patients inflicted with relapses before further treatment.
Conclusions:
Comprehensive evaluation including medical history, physical examination, ultrasound and MRI imaging of cervical spaces is required to assure the proper diagnosis of cervical cysts in children. Surgical removal remains the major modality for disease control. Majority of postsurgical complications are attributed to transitional injury of blood vessels or nerves. Recurrence of cysts is commonly associated with patients with TGDC and LM.
