Diagnosis and Management of Nasopharyngeal Branchial Cysts

Nasopharyngeal branchial cysts (NBCs) have been discussed in the literature in only a limited number of publications. Differing from Thornwaldt cysts, NBCs present laterally and arise from the fossa of Rosenmüller and may track superiorly within the bony confines of the eustachian tube. Initially, patients are asymptomatic but may present with aural fullness, unilateral conductive hearing loss, and serous otitis media as the cystic mass grows. Two of our three patients had the lesion incidentally identified at the time of assessment for another diagnosis. In this case series, imaging characteristics and response to treatment are reviewed. A literature search will be performed to summarize the management options for this entity, in addition to reviewing the differential diagnosis for cystic masses on the nasopharynx in the adult population.