Cervical cyst

definition

Neck cysts are congenital cystic swellings on the neck, which are usually visible and palpable and can become inflamed. Cysts are cavities that are filled with fluid. They can arise due to incorrect development of the throat viscera or are leftovers from the development of the throat organs. Depending on the localization, a distinction is made between median, i.e. middle, and lateral or lateral cervical cysts, which have different causes. Most often, neck cysts appear in children and are diagnosed before the age of 6. However, they can be observed at any age.

Causes of a Neck Cyst

Neck cysts can be caused by malformations of the neck viscera and disorders of the regression of embryonic structures. Tissue that can make cervical cysts is a remnant from the development of the cervical organs during the embryonic period. Depending on the location, whether in the middle or on the side of the neck, the causes of the cysts differ.

Medium-sized cervical cysts result from the failure of a channel that leads from the base of the tongue to the thyroid gland to recede. The inner layer of tissue in this thyroid duct forms mucus, which creates a fluid-filled cavity called a cyst. This channel should close before the birth. If he does not, there will be a visible and palpable swelling in the center line of the neck. It can get bigger, swell and become infected.

The cause of lateral neck cysts has not yet been conclusively clarified. It is believed that lateral cervical cysts, also called brachiogenic cysts, are remnants of gill arches, a structure of embryonic development. Usually a lateral cervical cyst emerges from the second of the total of six gill arches. A cavity forms, which normally disappears again. If this is not the case, part of it or a passage remains behind. This fluid-filled cavity is usually located laterally below a neck muscle.

Signs of a neck cyst

A sign of a neck cyst is swelling around the neck. This can be palpable or visible. A cyst can enlarge and become inflamed. The throat area may become red and there may also be a fever. If the fluid from a neck cyst drains through a small connection to the surface of the skin, a neck fistula develops.

Read more on the topic: Swelling on the side of the neck

Accompanying symptoms of a neck cyst

Depending on whether it is a medial or lateral neck cyst, the swelling is in the middle of the neck or on the side. With a medium-sized cyst, thyroid duct cysts can extend to the base of the tongue. When swallowing, the swelling moves with the swallowing movement.

If there is no inflammation, a cyst may be symptom-free or only cause a slight feeling of pressure in the neck area. If a cyst becomes infected, it can cause redness, fever, and severe pain.

Lateral neck cysts also show swelling. It can happen that lateral cysts have a connection to the tonsil in the throat. If this is the case, the cyst with a sore throat can swell and become painfully enlarged. Bacterial infections in the throat can spread to the cyst and suppuration can occur. This can lead to an abscess, fever and difficulty swallowing.

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OP of a neck cyst

When treating cervical cysts, the goal is complete surgical removal, as the cysts do not go away on their own and an inflammation can occur at any time. A thyroid examination should be performed prior to an operation to ensure that no untreated thyroid tissue is injured or removed during the operation. If a cyst is inflamed, it may be useful to puncture the fluid beforehand. With the removed fluid, an examination for the bacterial pathogens can be carried out and the appropriate antibiotic can be given. Once the inflammation has formed, the cyst can be surgically removed.

The operation can be performed under either local or general anesthesia. In the case of lateral cysts that have a connection to the palatine tonsils, the tonsils should also be removed (see also: Remove almonds). In the case of medial cervical cysts, it may be necessary to remove part of the hyoid bone if the cyst continues through a passage. If a cyst with a fistula (Connection to the skin surface), both must be completely removed.

After the operation, a tube (drainage) placed in the operating area so that blood and wound fluid can drain away. The hose can usually be removed after a few days. Complications of an operation can include bleeding and wound healing disorders. Furthermore, nerves in the neck area can be injured.

Duration of an operation

Surgery for a neck cyst can take anywhere from 30 to 90 minutes. A second operation, which may be necessary due to recurring cysts, is an exception and can take more time. The length of the hospital stay can vary greatly depending on the extent of the operation and the complications after the operation.

Prognosis after an operation

A recurrence of a cyst after an operation cannot be ruled out. However, if the entire cyst (with a possible fistula) has been removed, the chances of not getting a new cyst are better than if a part is left in the body. Otherwise, no further follow-up care is necessary for surgically removed neck cysts. However, if the swelling on the neck recurs, it is recommended to have it examined by a doctor.

Can cervical cysts be cancerous?

Usually, neck cysts are harmless. However, they can become infected. In rare cases, they can develop into cancer and become malignant. A middle cervical cyst, which is caused by a non-occluded thyroid duct, can contain thyroid tissue. This thyroid tissue can change and become cancerous. In this rare case, cancer can develop.

In the case of lateral cysts, which can arise from enlarged lymph nodes, it can happen that lymph gland cancer (Lymphoma) developed. These malignant cells migrate through other tumors in the brain or in the neck area and collect there. Direct tumors of a lateral cervical cyst are extremely rare.

The risk of tumors from a lateral cervical cyst is higher than from a medium one. The cyst can be punctured and the removed fluid or tissue can be examined for malignant changes. Even during an operation, the surgeon can send parts of the cyst to the pathologist and have them examined for abnormalities.

Difference between central and lateral neck cysts

The difference between central and lateral cervical cysts lies in the location of the cysts. Either the cyst arises in the midline of the neck (median) or laterally under a neck muscle (lateral). The causes of emergence also differ from each other.

Medium-sized cervical cysts are caused by a non-closing canal that runs from the base of the tongue to the thyroid gland. This thyroid duct should regress before birth. If this is not the case, a cavity can appear in the center line of the neck. The tissue that fills the cavity produces mucus and a cyst forms. Since medium-sized cervical cysts have a connection to the thyroid gland, thyroid tissue may be found in the cyst.

Lateral neck cysts, on the other hand, are based on undesirable development of the neck viscera. They can be remnants of what are known as the gill arches, structures of embryonic development. These should resolve before birth. If they do not, they can be the cause of lateral cervical cysts. Usually a lateral cyst develops due to a malformation of the second branchial arch. Another explanation for the development of a lateral neck cyst are epithelial inclusions in lymph nodes, which are located on the side of the neck. However, the causes of lateral cervical cysts are not yet fully understood.

What is the difference to a neck fistula?

A neck fistula is a weeping connection between a neck cyst and the surface of the skin. If a throat cyst becomes infected, the pus it contains can drain through this connection. Unlike a cervical cyst, a cervical fistula is not a closed cavity with fluid, but rather represents a duct structure from the pharynx to the outer skin surface on the neck.

Read more on this topic at: Throat fistula