摘要
背景：Tornwaldt氏囊腫為咽囊開口阻塞後分泌物聚積所形成，而咽囊則是在胚胎第2個月時，因脊索(notochord)退化與咽部內胚層相連，牽引上皮向內生長所形成之空腔。由於其症狀表現多樣而複雜，常造成診斷及處置上之困擾。 方法：台北榮民總醫院自1982年5月至1995年6月間，共對17例Tornwaldt氏囊腫施行手術。藉由回溯性病史分析，提出臨床經驗報告，並參考文獻做進一步之討論。 結果：患者無顯著性別差異，好發年齡群為55到70歲以及15到30歲之間，徵候包括鼻咽症狀10例，中耳積水3例，頸部腫塊1例，頭痛及腦神經麻痺2例，另有1例並無相關症狀。所有病例皆是由反射鏡或鼻咽內視鏡所發現，並根據病理報告得到診斷的確認。15名囊腫較小的病人接受造袋術，另2名囊腫直徑超過2cm的病人則分別接受經口和經腭的全切除手術，術後平均追蹤時間為15個月，全部病例之相關症狀均獲得緩解，具無復發產生。 結論：Tornwaldt氏囊腫在診斷上需注意不要誤診為鼻竇炎，且要排除鼻咽癌的可能。至於與其他鼻咽部囊腫的鑑別診斷，則可藉由病理檢查和發生的位置為之。治療以造袋術或全切除為主，預後良好，少有復發報告。
並列摘要
Background: Tornwaldt's cyst results from obstruction of the orifice of the pharyngeal bursa and subsequent accumulation of secretions, debris, or infected material within the bursa. During the sixth week of fetal life, notochordal remnants in the posterior wall of the nasopharyx may communicate with the pharyngeal epithelium. This connection allows ingrowth of respiratory epithelium, which creates the formation of pharyngeal bursa. The detection and evaluation of Tornwaldt's cyst are requently complicated by the variability and complexity of its clinical presentations. Methods: There were seventeen cases of Tornwaldt's cysts all of which underwent surgical treatment in the Department of Otorhinolaryngology of VGH, Taipei between May 1982 and June 1995. The incidence, clinical features, and treatment of these cases are presented in associated with a review of the literature. Results: No sex predilection was noted. There were two peak incidences in the ranges 55 to 70 years and 15 to 30 years. Clinical features included related nasopharyngeal symptoms in 10 cases, middle ear efffusion in 3 cases, cervical lymphadenitis in 1 case, and headache and cranial nerve palsy in 2 case, and headache and cranial nerve palsy in 2 cases. One case was detected incidentally without corresponding symptoms or signs. All cases were discovered by mirror or endoscopic examination of nasopharynx, and the diagnoses were all confirmed by pathological studies. Surgical Management contained marsupialization in 15 cases and total excision in 2 cases. Complete relief of the symptoms without recurrence was obtained in all cases. Conclusions: Tornwaldt's cyst should not be misdiagnosed as chronic paranasal sinusitis, and it is essential to consider the possibility of nasopharyngeal malignancy. The various types of nasopharyngeal cysts may be anatomical site and pathological findings. Marsupialization or complete excision is the preferred treatment with low incidence of recurrence.