Vol.97 No.7 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 97 No. 7 July 2004
A Case of a Nasopharyngeal Cyst (Tornwaldt's Disease)
Found from Otitis Media Effusion
Daisuke Takada, Atsushi Kawano, Tomoyuki Yoshida,
Susumu Araki and Mamoru Suzuki
(Tokyo Medical University)
We reported a case of nasopharyngeal cyst (Tornwaldt's disease) found from otitis media effusion. A 49-year-old woman showed hearing loss and left ear fullness since December, 2000, and was hospitalized at our related hospital on February 3rd, 2001. Otitis media effusion of bilateral ears were identified by an otoscopic exam. Her mean hearing level was 40.0dB on the right side (A-B gap 12.5 dB) and 56.3 dB on the left side (A-B gap 35.0 dB). The finding of the tympanogram was B type on both sides. By fiberscopic examination, a smooth and slightly reddish globular mass was found in the center of the nasopharynx. No apparent stenosis of the pharyngeal opening of auditory tube and lesions on the other upper airways were identified. On enhanced brain CT, a round and uniform inner low density area was identified in the middle of the nasopharynx, adjacent to the front of bilateral musculus longus capitis. It was low on enhancement. On an MRI T1 enhanced image, an inner uniformly low intensity area was identified at the center of nasopharynx, and on a T2 enhanced image, a uniformly high intensity area was identified. From the above-mentioned findings, we diagnosed it as a nasopharyngeal cyst supposed to be Tornwaldt's disease that caused otitis media effusion, according to the infection on the remains of the nasopharyngeal bursa of the embryonic period.
Key words : nasopharyngeal cyst, Tornwaldt's disease, otitis media effusion, MRI, nasopharyngeal bursa