A cyst is a closed, sac-like pocket of tissue usually filled with air, fluid, or semi-solid material. Cysts can form in the throat, an occurrence more common than many realize. These growths are typically benign, meaning they are not cancerous, and they develop due to biological mechanisms within the soft tissues of the throat and surrounding neck structures. While the presence of a cyst can sometimes go unnoticed, its size and precise location determine if it eventually causes bothersome symptoms.
Where Throat Cysts Form
Cysts can manifest in several distinct anatomical areas of the throat and its immediate vicinity. Laryngeal cysts form within the larynx (voice box), often found in the supraglottic region above the vocal cords, such as the epiglottis or vallecula. These growths typically involve the mucosal lining or the underlying glandular tissue of the airway.
Another common type is the tonsillar cyst, often a retention cyst that develops on the palatine tonsils. These generally harmless cysts can appear as small, whitish-yellow bumps on the tonsil surface. Congenital cysts, such as thyroglossal duct cysts, form in the center of the neck but are related to throat structures, positioned along the developmental tract of the thyroid gland. The specific site of formation determines the potential symptoms and the appropriate medical approach.
Recognizing the Signs of a Throat Cyst
The symptoms experienced by an individual with a throat cyst depend on the cyst’s size and its exact placement within the throat structures. A cyst impacting the vocal cords in the larynx can cause noticeable changes in voice quality, often presenting as chronic hoarseness or a rough, breathy vocal tone. Even small cysts in this area can interfere with the precise vibration needed for clear speech.
Larger cysts or those located in the pharynx may lead to a persistent sensation of a lump or foreign body in the throat, a feeling medically termed globus sensation. This can prompt a person to frequently clear their throat. Difficulty or pain when swallowing (dysphagia) is another symptom that can arise as the cyst physically obstructs the passage of food or liquid.
If a cyst grows large enough to partially block the airway, it can cause chronic coughing or, in rare cases, difficulty breathing (dyspnea). Many smaller cysts remain entirely asymptomatic until they are discovered incidentally during an unrelated medical examination. If any symptoms, particularly hoarseness, persist for more than two weeks, a medical evaluation is recommended.
Why Throat Cysts Develop
Throat cysts generally develop through two primary pathways: they are either acquired during life or are present from birth as congenital anomalies. Acquired cysts often arise from the blockage of small ducts within the mucosal glands that line the throat. These are frequently referred to as retention cysts because the normal secretions become trapped, leading to fluid accumulation and cyst formation.
Inflammation, chronic irritation, infection, or minor trauma to the throat tissue can all contribute to the obstruction of these glandular ducts. For example, long-term irritation from smoking might cause localized swelling that impedes the flow of mucus. Over time, the pressure from the trapped secretions causes the duct or gland to swell into a fluid-filled sac.
Congenital cysts result from developmental abnormalities that occur before birth. Thyroglossal duct cysts, the most common type of congenital neck mass, form when the embryonic pathway used by the thyroid gland to descend fails to completely close and dissolve. Remnants of this temporary channel can persist and later fill with fluid and mucus. Branchial cleft cysts develop from remnants of embryonic structures called branchial arches, which are involved in the formation of the head and neck.
Clinical Diagnosis and Treatment Options
Confirming the presence of a throat cyst begins with a thorough physical examination by a healthcare provider, often an ear, nose, and throat specialist (otolaryngologist). The doctor will assess the patient’s symptoms and may attempt to palpate any external lumps to see if they move when the patient swallows or protrudes their tongue.
To visualize the internal throat structures, a procedure called laryngoscopy or endoscopy is typically performed, which involves inserting a thin, flexible tube with a camera into the throat. Imaging studies, such as a Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI), provide detailed cross-sectional views. These help determine the cyst’s exact size, location, and its relationship to nearby structures. To definitively rule out malignancy, especially in larger or suspicious growths, a biopsy may be required, which involves taking a small tissue sample for laboratory analysis. Fine-needle aspiration is a less invasive biopsy technique used to draw fluid from the cyst for further testing.
Treatment for a throat cyst depends on its type, size, and the severity of the symptoms it causes. Small, asymptomatic cysts may simply be monitored with a strategy of observation, involving regular check-ups to ensure the cyst does not grow or become problematic. If the cyst is causing significant symptoms, such as voice changes, breathing difficulties, or recurrent infection, surgical excision is the standard treatment. The goal of surgery is complete removal of the cyst wall to minimize the risk of recurrence. For thyroglossal duct cysts, a specialized procedure called the Sistrunk procedure is often performed, which involves removing the cyst, the central portion of the hyoid bone, and the entire tract to achieve a lower recurrence rate.