トーンワルト病について

抄録

Tornwaldt's disease, which was first described by Tornwaldt as one of the causes of epipharyngitis, is inflammation or abscess of the embryonic remnant cyst of the pharyngeal bursa appearing at the posterior median wall of the epipharynx. Although many cases are asymptomatic, symptoms are often caused by nasal tamponade, trauma, adenotomy, or other mechanical stimuli. Only a few cases have been reported from 1929 till 1992 in Japan. In about the 10th week of embryonic development the pouch, which is made by adhesion of the pharyngeal ectoderm to the notochord at the most cranial end of the notochord, is closed at the orifice (cystic type), or crusts adhere to the orifice without closing (crust type). The symptoms are those of upper respiratory tract infection with obstinate occipital pain, purulent choanal discharge, nasal obstruction, halitosis, feeling of ear fullness, clearing of the throat, etc. Posterior rhinoscopy, simple lateral view X-ray tomography, nasopharyngeal fiberscopy, CT scan and MRI are useful in showing adhesion to the cervical vertebrae. While complete extirpation via a transpalatal approach is desirable, incision or excision of the cyst can also be performed.