Lympho-epithelial cysts: a maxillofacial surgeon's perspective

Cervical swellings are referred to Oral and Maxillofacial Surgeons and may subsequently be diagnosed as lympho-epithelial cysts. The clinical presentation of such swellings appears to differ from that seen in other specialties also treating these cysts in that a larger proportion of lympho-epithelial cysts presenting to our specialty are infected, which complicates the diagnosis and also the subsequent management. We present our recent experience of 5 patients who underwent excision of a lympho-epithelial cyst, all of which were infected on initial presentation and four of which were associated with concurrent ipsilateral dento-alveolar infection. The fifth case presented with rapid development of a cervical swelling in the immediate post-natal period. As these cysts contain abundant lymphoid tissue as an integral part of the lymph drainage system of the head and neck, we propose that the management of an infected lympho-epithelial cyst should include a full clinical and radiographic examination of the oral cavity for a possible focus of infection and indeed any patient awaiting surgery for a non-infected cyst would benefit from an examination of the mouth and treatment of any sites of chronic infection.