[The pathogenesis of the nasopharyngeal bursa (Tornwaldt's disease) (author's transl)].

The pharyngeal recess, first described in 1842 by Mayer, is a cavity in the middle of the nasopharynx, just between the nasal septum and the ventral tuberculum atlantis. It was assumed to be an excavation of the pharyngeal mucous membrane often persistantly fixed to the embryonic spine (Chorda dorsalis). It might be therefore, looked upon as a malformation. The recess is always stuffed with mucous membrane of the pharyngeal tract and ends next to the adenoids. It might pass into the occipital bone as an epithelialized cleft surrounded by connective tissue. Cystic transformation of the recess was first described by Tornwaldt in 1885, causing discomfort in the epipharyngeal and adjacent areas, and was named Tornwaldt's disease. The clinical data of 12 patients with pharyngeal cysts are presented. The conclusion is made, that we have evident lack of knowledge between the rare clinical manifestation of the pharyngeal recess only in adults on the one hand and the almost constant presence of the pharyngeal recess in human embryos on the other. It is therefore assumed, that frequent inflammatory discharge of the nasopharynx during life initiates the development of the nasopharyngeal cyst and not vice versa.