Congenital head and neck masses

John P. Maddolozzo*, Sandra Koterski, James W. Schroeder, Hau Sin Wong

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Key Points: A thyroglossal duct cyst is the most common congenital neck mass. Its evaluation and diagnosis can be performed with ultrasonongraphy that is noninvasive and cost-effective. A Sistrunk procedure is the recommended surgical resection. Branchial cleft anomalies result from abnormal development of the branchial apparatus, forming sinuses, fistulas, or cysts. Second branchial anomalies are the most common, occurring along a tract that extends deep to the second arch structures. The treatment for all branchial anomalies is surgical excision. Dermoids and teratomas are composed of one to three germ layer components. Surgical excision is the treatment of choice but needs to be tempered by the relation of the tumor to critical structures. Lymphatic malformations have varying histologic and anatomic features that assist in predicting the likely response of these neck masses to various treatment modalities. Single cysts and macrocystic lymphangiomas are most amenable to sclerotherapy, but are also easily treated with surgical resection. Microcystic and cavernous lymphangiomas are less successfully treated with sclerotherapy and/or surgical resection and may need multiple resections. Thymic anomalies result from thymic rest cells that are deposited in the neck during development. Thymic cysts are the most common thymic anomalies and often mimic second branchial cleft cysts. Surgical excision is the preferred treatment. Fibromatosis coli, which presents in the first few weeks of life, results from edema and fibrosis of the sternocleidomastoid muscle. Spontaneous resolution within the first year of life is the rule, but physical therapy should be initiated if neck rotation is limited.

Original languageEnglish (US)
Title of host publicationPediatric Otolaryngology for the Clinician
PublisherHumana Press
Pages129-135
Number of pages7
ISBN (Print)9781588295422
DOIs
StatePublished - Dec 1 2009

Keywords

  • Branchial anomalies
  • Dermoid
  • Fibromatosis coli
  • Lymphatic malformation
  • Teratoma
  • Thymic cyst
  • Thyroglossal duct cyst

ASJC Scopus subject areas

  • Medicine(all)

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