Incidental discovery of Tornwaldt’s cyst during evaluation for suspected obstructive sleep apnea syndrome in a patient with auditory symptoms

Tornwaldt’s cyst is a rare, congenital lesion of the nasopharynx due to incomplete regression of the notochordal-pharyngeal connection. It forms a midline cystic cavity in the pharyngeal bursa. While often asymptomatic, symptomatic cysts may cause nasal obstruction, postnasal drip, halitosis, occipital headache, or Eustachian tube dysfunction. Diagnosis relies on nasal endoscopy revealing a well-circumscribed cystic mass in the posterior nasopharynx. High-resolution CT assists by demonstrating a low-attenuation midline lesion, aiding differentiation from other masses. Histology confirms the diagnosis. Management is conservative for asymptomatic cases; symptomatic cysts require surgical excision or endoscopic marsupialization, with excellent outcomes and low recurrence rates.

We report a 25-year-old male with suspected obstructive sleep apnea syndrome and auditory symptoms. Imaging revealed a Tornwaldt cyst. Early diagnosis and multidisciplinary management are essential to optimize outcomes.