Tornwaldt Cyst

By | June 10, 2022

The Tornwaldt cyst is a benign cyst in the back of the nose and throat (medical term nasopharynx). Tornwaldt’s cyst is filled with a special fluid and is also known as a pharyngeal bursa by some doctors.

What is a Tornwaldt’s cyst?

The Tornwaldt cyst is a benign type of cyst in the upper area of ​​the [[nasopharynx. In the majority of cases, the Tornwaldt cyst is discovered by chance during other examinations by the doctor. It usually appears for the first time during CT or MRI examinations when such imaging methods are used in the area of ​​the head. For peters-plus-syndrom dictionary definitions, please visit

Tornwaldt’s cyst presents as a mass with an approximately round contour and a clear demarcation from the surrounding tissues. It is usually on the midline. Basically, the Tornwaldt cyst represents a very common mass of a benign nature in the area of ​​the so-called nasopharynx.

Previous studies indicate that it is the most common congenital form of cysts in the area concerned. About one to four percent of people have a Tornwaldt’s cyst, which is often diagnosed with radiological imaging methods. In many cases, the cyst shows no particular symptoms and therefore often goes undetected.


The causes of Tornwaldt’s cyst are widely known according to various medical research studies. The formation of the cyst is based on a connection between the primitive pharynx and the notochord. This anomaly develops in the womb in the embryo. As a result, a bulge develops in the area of ​​​​the mucous membrane of the nasopharynx. The Tornwaldt cyst is therefore usually already present when the patient is born. However, not all cases are diagnosed because Tornwaldt’s cysts are often asymptomatic.

Symptoms, Ailments & Signs

The Tornwaldt cyst is usually located on the so-called midline, which is due to the development of the cyst in the embryo. In many cases, Tornwaldt’s cyst has a thickened wall. In addition, it often contains a slimy filling. If the Tornwaldt’s cyst is infected, the filling may be made of purulent matter. In the majority of cases, however, the disease is completely symptom-free.

Symptoms from Tornwaldt’s cyst usually do not arise until an infection develops. These are mostly infections affecting the upper nasopharynx. As a result, a secondary infection develops in the area of ​​the Tornwaldt cyst. The typical symptoms of such an infection of the Tornwaldt cyst consist of a feeling of pressure, which in the worst case restricts the mobility of the spine in the neck area.

Affected patients experience pain originating from the Tornwaldt cyst, which often progresses to headaches. In addition, breathing through the nose is difficult, which may result in sleep apnea. Some patients report a foreign body sensation in the area of ​​the Tornwaldt’s cyst. Sometimes pus is released into the mouth, resulting in an unpleasant bad breath.

If the auditory tube is displaced, otitis media and a seromucotympanum sometimes develop. Tornwaldt’s cyst sometimes affects the patient ‘s hearing. The glands located in the nasopharynx may produce mucus that causes bad breath. If Tornwaldt’s cyst is not treated appropriately, there is a risk of chronic inflammation. As a result, the tuba auditiva is often affected by the infection.

Diagnosis & course of disease

The Tornwaldt cyst is usually only diagnosed when it causes significant symptoms in the patient due to infection. Asymptotic Tornwaldt cysts, on the other hand, are often discovered by accident. If people suffer from the typical symptoms of an infected Tornwaldt cyst, either a general practitioner or an ear, nose and throat specialist should be consulted.

In the patient consultation, the doctor clarifies the symptoms and the background of the pathogenesis and decides on the further course of the examination. During the clinical examination, the doctor first inspects the patient’s nose and throat for changes or abnormalities. MRI and CT scans of the head are then usually used to visualize the Tornwaldt’s cyst.

If the image shows the typical form of the Tornwaldt cyst in connection with the described symptoms of the patient, the diagnosis is considered relatively secure. However, it is obligatory to carry out a differential diagnosis, for which in many cases endoscopy of the nasopharynx is used.

The doctor will check for retention cysts, nasopharyngeal fibroma, or a cyst on Rathke’s pouch. In addition, he rules out the presence of adenoid vegetations, lymphoma, or a Baker’s cyst. In addition, the Tornwaldt cyst must be differentiated from a carcinoma of the nasopharynx and halitosis.


Complications from a Tornwaldt’s cyst usually don’t arise until the growth becomes inflamed. If left untreated, the infection can spread from the Tornwaldt cyst to the entire nasopharynx and ear canals. If it spreads further, it can lead to an ear infection, for example. The infection can also cause an uncomfortable feeling of pressure, which in the worst case can lead to a stiffening of the cervical spine.

Usually there is also a headache and nasal breathing becomes more difficult. In extreme cases, this results in sleep apnea. A Tornwaldt’s cyst can also impair hearing and cause chronic inflammation. Life-threatening blood poisoning occurs very rarely. Surgical removal of a Tornwaldt’s cyst can cause secondary infections in the area of ​​the procedure.

Bleeding, secondary bleeding and wound healing disorders can also occur. A new formation of the Tornwaldt cyst is not improbable and makes a new intervention necessary. The drug treatment is usually free of complications, since mainly mild antibiotics and painkillers are prescribed. Occasionally, however, side effects and allergic reactions occur. Patients who regularly take other medications may also be affected by drug interactions.

When should you go to the doctor?

Since this disease cannot heal itself, the person affected with the Tornwaldt cyst is dependent on medical treatment in any case. This is the only way to avoid further complaints and a further deterioration of the symptoms. Therefore, a doctor should be consulted at the first signs and symptoms of Tornwaldt’s cyst. The doctor should be consulted if the person concerned suffers from very severe headaches. These usually do not go away on their own and last for a very long time. Difficult breathing can also indicate the Tornwaldt cyst, whereby the person concerned can hardly breathe through the nose. Pus forms in the mouth, which usually also leads to a very strong bad breath.

If these symptoms occur, an ENT doctor or a general practitioner should be consulted. The further treatment is then usually carried out by a surgical intervention by a specialist and completely alleviates the symptoms.

Treatment & Therapy

The treatment of Tornwaldt’s cyst depends on the course of the disease. An asymptotic Tornwaldt’s cyst usually does not require any specific therapy, especially since in most cases it remains undetected anyway. In general, the Tornwaldt cyst is removed or split as part of a surgical procedure. This usually improves the level of suffering for the patient considerably. However, potential recurrences or secondary infection in the area of ​​the intervention are problematic.


A concrete prevention of the Tornwaldt cyst has not been researched, because the disease is already present in the sick patients from birth.


A Tornwaldt’s cyst does not require long-term follow-up care. The cyst can usually be surgically removed. After the operation, inpatient treatment is necessary. The patient will have to stay in the hospital for about one to two weeks, depending on the course of the operation. As a rule, short-term observation is sufficient before the patient is allowed to leave the clinic again.

However, should complications arise, referral to a specialist dermatological clinic is necessary. In order to detect recurrences at an early stage, regular medical check-ups are indicated. Patients should contact the responsible dermatologist if complications develop or unusual symptoms appear. The risk of a secondary infection is relatively high and regular medical examinations are therefore all the more important.

As part of the follow-up care, the drug treatment is also checked and adjusted if necessary. If accompanying symptoms develop, such as inflammation in the area of ​​the intervention or pain, the patient needs accompanying medication in the form of painkillers or anti-inflammatory drugs. In addition, a Tornwaldt cyst can lead to sensory disturbances. Massages or alternative measures such as acupuncture are therefore often useful as part of aftercare. The exact measures are discussed between the dermatologist and the patient.

You can do that yourself

Patients with Tornwaldt’s cyst do not generally suffer from symptoms. However, symptoms appear in some sufferers during the course of the disease and impair the quality of life.

The pain caused by the Tornwaldt cyst is initially counteracted by those affected with drug treatment, the course of which is prescribed by the doctor. Patients with Tornwaldt’s cyst strictly follow the doctor’s instructions. The same applies to headaches associated with Tornwaldt’s cyst. Bad breath associated with the disease can be partially reduced through adequate oral hygiene, but not completely eliminated, since the cause in the form of the Tornwaldt cyst persists.

If patients suffer from severe symptoms that significantly reduce their quality of life, prompt surgical removal of the Tornwaldt cyst should be sought. In the run-up to the operation, those affected pay more attention to physical protection and a lifestyle that is as healthy as possible. Surgical removal is probably the most effective way of treating Tornwaldt’s cysts.

After the operation, the patients give themselves enough time to regenerate and ensure that the scars heal without complications. Meanwhile, people usually abstain from exercise and also take care not to contract contagious respiratory diseases. Because such an infection could interfere with the healing process after Tornwaldt’s cyst removal.

Tornwaldt Cyst