TRANSNASAL ENDOSCOPIC SURGERY BY POWERED INSTRUMENTATION IN THE TREATMENT OF SYMPTOMATIC NASOPHARYNGEAL CYSTS- OUR EXPERIENCE

Abstract

Lakshmi Ananth, Pradeep Hanumanthagouda Hosamani, Nithya Venkataramani

BACKGROUND Nasopharyngeal cysts are rare lesions. Usually asymptomatic, they are found during routine nasal endoscopies and imaging studies. Symptomatic cysts are relatively uncommon, very few cases have been reported in literature and require treatment in the form of surgery. We present our experience in transnasal, endoscopic-guided surgical treatment of nasopharyngeal cysts with the aid of powered instruments along with symptomatology of the nasopharyngeal cysts and the efficacy and outcomes of the procedure. MATERIALS AND METHODS We retrospectively reviewed twelve patients from January 2013 to June 2017 with symptomatic nasopharyngeal cysts treated at a tertiary referral centre. The symptoms and signs were assessed, and all the patients underwent Nasal Endoscopy, MRI, or a CT scan. All the patients underwent transnasal endoscopic powered instrument assisted marsupialisation of the cyst. The patients were followed up for a minimum of six months. RESULTS All the patients were symptom-free on follow up of 6 - 36 months with no major complications. There were no recurrences noticed in the follow up period. Histopathological examination showed features of Tornwaldt’s cysts in four cases, mucus retention cysts in six cases and intra-adenoid cysts in two. CONCLUSION While nasopharyngeal cysts are often detected incidentally on imaging studies, symptomatic cysts are uncommon and need definitive treatment. Marsupialisation of the cyst by powered instruments is precise and effective without any major complications.

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