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DR. MANEL BARDAJIDR. MANEL BARDAJI
Bardají Bofill ManelCirugía General Adultos
Descripción Servicios Equipo Contacto Datos de interés Horario
Cervicofacial cysts

In this group we find cystic lesions of recognized congenital origin, such as branchial cysts, as well as cysts associated with endocrine glands and salivary thyroid cysts, parathyroid and salivary mixed tumors that without being congenital, represent a frequent pathology that we will find in the head and neck. We also include those cysts associated with cutaneous structures, of uncertain etiology, among is the dermoid cyst of congenital origin that comes to represent in the facial field, which at the cervical level are the gill cysts.

    • Embryology
    • Fistulas, sinuses and branchial cysts
    • Congenital atrial fistulas
    • Thyreoglossus duct cyst

  • What are they?

    These cysts, sometimes acquired and sometimes of congenital origin, are lesions with their own characteristics, associated with endocrinological glands such as the thyroid, parathyroid and thymus, and those associated with salivary glands. Its correct diagnosis will allow its adequate surgical treatment.

  • The mixed tumor or pleomorphic adenoma is applied to all tumors of the salivary and skin glands containing mesenchymal epithelial elements. 90% of cases are mainly located in the parotid; 7%, in the submaxillary gland and palatine vault; 1% in the sublingual glands and the remaining 2-3% in the accessory, sweat and lacrimal glands, having been described in order of frequency in jugal mucosa, neck, lips, cheeks, eyelids, etc.

  • Cysts associated with cutaneous structures

    What are they?

    These highly frequent cysts are epidermal, sebaceous and dermiode.

    • Epidermal cyst: The epidermal cyst is a benign tumor of the skin, of ectodermal origin, which is located in an intracutaneous or subcutaneous position; These cysts can be located anywhere on the body but predominate in the head and neck. They can be single or multiple, of familial origin, with dominant transmission and of variable size, encapsulated of elastic or soft consistency in relation to the overlying skin, of normal appearance or with some telangiectasia.
      The epidermal cyst anatomopathologically is formed by a fibrous capsule, lined with layered paved epithelium with pasty or liquid content formed by keratin. Its etiology is unknown, and it tends to be affirmed that they are produced by keratinizing metaplasia of the excretory duct of the sweat glands or hair follicles or by traumatic inclusion of Malpighio cells in the dermis.
      Treatment is always surgical, and should include the cyst capsule and its contents      .
    • Quiste Sebáceo: It is a cystic formation similar to the previous one, but it communicates with the exterior through a central depression. Anatomopathologically, its internal wall is lined with a pavement-like epithelium and its content is oily, containing a pasty substance with an unpleasant rancid odor. It is located in seborrheic areas and tends to become infected. The treatment is surgical and must include in the resection a skin spindle that contains the communication with the exterior.
  • Dermoid cyst

    What is it?

    It is a subcutaneous cystic formation covered with normal skin, adhered to deep planes, sometimes to the bone, where it forms an excavation with decreasing thickness; Its consistency is hard or renitentient. Cysts located on the face and neck are relatively frequent; They represent 10% of all dermoid cysts in the body. They settle mainly in the embryonic clefts and sutures, predominating the locations in the periorbital regions, middle frontal line, eyebrow tail, nose and cervical midline.

    Anatomopathologically, its inner wall is covered with epidermis with rudimentary or fully developed annexes. Its content is mucoid and sometimes houses hairs and, more rarely, other tissues. They develop from embryonic remains, their treatment being invariably surgical.

    Cysts located on the tail of the eyebrow are very common in children, are always present at birth and grow slowly. They are not attached to the skin, but to the deep tissues and sometimes to the periosteum, lodging within a small cavity in the frontal bone above the orbital ridge. It is necessary to establish the differential diagnosis with lipomas and angiomas in this region. Its removal is done by incisions on the eyebrow.

    The cysts of the nose are located almost exclusively in its midline, extending in depth towards the own bones, lamina cribosa and encephalon, upwards to the frontal bone and downwards to the bony palate; For this reason, the radiographic study is essential to determine the bone distortion caused by the cyst, as well as to establish the differential diagnosis with the encephalocele. Clinically they manifest in the middle or distal part of the dorsum of the nose through a small punctate hole through which hairs appear and periodically a purulent exudate. Other times, the least, they cross the lateral faces of the bones themselves or the suture line where these bones meet. For its excision is performed, a longitudinal incision is made in the back of the nose, so that it covers the hole and the fistulous path, and the central osteotomy through the suture of the bones themselves to separate it and have access route to the cyst. When the cyst cannot be removed in its entirety, it marsupializes to the nostril.

    Cervical midline dermoid cysts are preferably located in the submental region, making prominence towards the skin or towards the sublingual region. They are rounded, painless, asymptomatic tumors due to their slow growth, not adhered to the skin, but sometimes they are to the genian process of the jaw. It is necessary to establish the differential diagnosis with the thyreoglossal cyst, with the groulas and the cyst of dental origin. Dermoid cysts are usually more superficial, centrally located higher than those of the thyreoglossus duct and are not attached to the hyoid bone, and a large number of them make prominence on the floor of the mouth. With the slot, whose wall is thinner, almost transparent, with a bluish content and its location is just in the middle line. With regard to fistulas of dental origin, they are not usually central and are related to a dental infectious focus. Its removal is done by incision in the submental region.

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