Thornwald's Bag
This is a benign congenital cyst-like formation that is located on the back wall of the nasopharynx.
Thornwald's bag is a small formation in the nasopharynx, resembling a cyst or pocket, located in the same place where children have adenoids. It is formed due to a violation of the embryonic development of the nasopharyngeal mucosa, when the nasopharyngeal pocket does not completely close.
Reasons:
For the development of a clinical disease, a bag (cyst) Tornvalda should be present in a person from birth. It is formed in the embryonic period of development of the nasopharyngeal mucosa, if the nasopharyngeal pocket does not completely close. In the future, under the influence of provoking factors, infection of the bag may occur, an increase in its volume and the appearance of symptoms of the disease.
Predisposing factors:
Frequent infections of the nasal cavity and nasopharynx, especially chronic long-term adenoiditis.
Allergic reactions that predispose to infection in the nasopharynx.
Adverse environmental factors and occupational hazards (e.g. inhalation of harmful substances or biological agents).
Stress.
Symptoms:
Runoff of discharge from the nasopharynx along the back wall of the pharynx, most often purulent in nature with an unpleasant odor, or a feeling of a lump between the nasopharynx and pharynx.
Frequent difficulty in nasal breathing.
Chronic nasal discharge.
Frequent upper respiratory tract infections.
Bad breath.
Frequent sore throat.
Stuffy ears.
Effects:
Without treatment, Tornwald's cyst can lead to recurrent nasopharyngeal infections and chronic inflammatory processes — rhinitis, recurrent inflammatory processes of the pharynx and lower respiratory tract.
Лечение
Conservative treatment:
Conservative treatment may include the use of nasal sprays to reduce the symptoms of inflammation and relieve swelling, antibacterial therapy in the presence of purulent inflammation, as well as irrigation to cleanse the nasal cavity. If an allergy is detected, the allergist prescribes appropriate therapy. In the presence of complications, pronounced symptoms or ineffectiveness of conservative therapy, surgical removal of the Tornwald bag is indicated.
Surgical treatment:
Thornwald cyst removal surgery is performed endoscopically under general anesthesia. The modern method of choice is to use a microdebrider (shaver), which gently removes the altered tissues inside the cyst cavity. At the end of the operation, coagulation of the wound surface is performed (using the radio wave method, laser or other technologies) to prevent bleeding. This method allows you to minimize the trauma of the nasopharyngeal tissues and at the same time perform the operation efficiently, completely cleansing the cyst cavity. After surgery, the patient can be discharged home on the same day or the next. Soreness after the intervention is usually absent. During the week after the operation, it is recommended to refrain from physical exertion and air travel, and individual recommendations can also be given.
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