Wednesday, 30 September 2015

Spontaneous Cyst of the Cervical Segment of the Thoracic Duct: Literature Review

Roger V*, Babin E  Hitier M, Capovilla M and Blanchard D
Abstract: 
Objective: Cervical cysts are common pathologies in Otorhinolaryngology head and neck surgery. Cysts of the cervical segment of the thoracic duct are poorly understood, but require very specific treatment, as there is a risk of complications. In this work, we outline the particularities of this pathology and the debate surrounding its management.
Materials and Methods: Personal experience of one case and a literature review.
Results: Thirty-four cases of cervical cysts of the thoracic duct have been reported. They are characterized by dilation of the terminal portion of the thoracic duct, just above the left subclavian jugular confluence or in one of the two vessels of which it is composed. They are typically asymptomatic and discovered by chance. Diagnosis of these cysts is based on MRI, perioperative observation (cysts that communicate with the thoracic duct) and anatomopathologicial examination (vascular wall of the cyst). Their treatment remains controversial. Surgical excision becomes an option if the cysts are symptomatic, unsightly or if they are at risk of rupture. Identification and ligation of the thoracic duct are then essential in order to prevent lymphorrhea.
Conclusion: Cervical cysts of the thoracic duct are benignant but must be recognized by the ENT surgeon in order to avoid iatrogenic complications.

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