Endoscopic Management of a Large Tornwaldt Cyst: A Case Report
Objective: To report successful marsupialization of a large Tornwaldt cyst using combined transnasal and transoral endoscopic surgery in a 7-year-old girl who presented with nasal obstruction.
Design: Case Report
Setting: Tertiary Government Training Hospital
Result: A 7-year-old girl presented with an 11-month history of recurrent yellowish nasal discharge gradually associated with nasal obstruction. Examination revealed a large, well encapsulated, broad-based cystic mass in the nasopharynx immediately adjacent to the posterior choanae, continuing posterior to the soft palate (pushing the uvula anteriorly) and extending inferiorly to the epiglottic area. Computerized Tomography (CT) demonstrated a well-circumscribed, midline hypodense mass with fluid attenuation obstructing the nasopharyngeal area extending inferiorly to the oropharyngeal area. Endoscopic marsupialization via transnasal and transoral approach was successful, and a respiratory epithelium-lined cyst consistent with a Tornwaldt cyst was confirmed by histopathologic examination
Conclusion: Combined transnasal and transoral endoscopic marsupialization is possible a for a large symptomatic Tornwaldt cyst in a pediatric patient with relatively smaller and complex nasal cavities.
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