The nasopharynx is a cuboidal compartment extending from the base of the skull to the soft palate. Thornwaldt’s bursa, also known as nasopharyngeal bursa, is a recess in the midline of the nasopharynx, which is produced by persistent notochord remnants. If the opening of the bursa is occluded, benign midline nasopharyngeal mucosal cyst called Thornwaldt cyst develops. Thornwaldt cysts are almost always asymptomatic. However, if they become infected or exposed to trauma they can cause some symtoms include halitosis, occipital headache and postnasal drip. The diagnosis of this mass is usually incidental as part of a nasal endoscopic examination. Radiological and endoscopic examination can be used to diagnose the cyst. Radiographs frequently demonstrate a soft tissue mass with sharply defined margins high on the posterior pharyngeal wall. The differential diagnosis should include a meningocele or meningo-encephalocele. Various therapeutic approaches, including endoscopic, transoral, or transpalatal surgical interventions, can be used for treatment of symptomatic cysts.
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