Main features and treatments of cervical cysts in children from a single-center experience.

Background: The cervical cysts is one of the most common children ailments an ENT surgeon encountered, which often begins with painless masses in the neck. The present study summarizes main clinical features of various types of children cervical cysts and discusses the possible approaches and associated complications, with an aim to improve the diagnosis and treatment of this pediatric disease.

Methods: We retrospectively analyzed the clinical data of patients admitted with cervical cyst to Beijing Children's Hospital, Capital Medical University from January 2018 to December 2023. Analysis focused on the clinical presentation, medical imaging, surgical approach, treatment-related complications as well as disease recurrence.

Results: The main self-reported symptom at first admission was painless masses at neck and submandibular space accompanied by sleep apnea, laryngeal stridor, odynophagia or hoarse voice. Three hundred and eighty-four patients received cervical ultrasound examination, whereas 92 patients were subjected to cervical MRI. The median of cysts size recorded by medical imaging was 1.7 cm*1.0 cm*1.6 cm. The median operation duration was 55 min. Histology of removed cysts indicated five main pathological categories including thyroglossal duct cyst (TGDC), branchial cleft cyst (BCC), dermoid cyst (DC), lymphatic malformation (LM) and bronchogenic cyst (BC). The most frequent postsurgical complication was dysphagia and inflammatory wound swelling. Seven patients inflicted with relapses before further treatment.

Conclusions: Comprehensive evaluation including medical history, physical examination, ultrasound and MRI imaging of cervical spaces is required to assure the proper diagnosis of cervical cysts in children. Surgical removal remains the major modality for disease control. Majority of postsurgical complications are attributed to transitional injury of blood vessels or nerves. Recurrence of cysts is commonly associated with patients with TGDC and LM.