Diagnosis and management of congenital vallecular cyst: An institutional experience

Yıl 2020, Cilt: 30 Sayı: 3, 81 - 86, 20.09.2020

Serap Şahin Önder Gözde Günay Aslı Şahin Yılmaz Özgül Gergin

Öz

Objectives: This study aims to evaluate the clinical presentation, diagnosis, and management of infants with a congenital vallecular cyst VC . Patients and Methods: Four infants 2 males, 2 females; mean age: 45±17 days; range, 28 to 63 days who were operated or followed for a congenital VC were retrospectively analyzed between January 2016 and March 2020. Data including patient demographics, major symptoms cyanosis, inspiratory stridor, suprasternal retraction, difficulty feeding , diagnostic methods, type of coexisting anomalies, surgical procedures, and length of follow-up and recurrence were recorded. Results: All patients presented with varying degrees of respiratory symptoms including inspiratory stridor and suprasternal retraction. The diagnosis was made based on awake flexible fiberoptic laryngoscopy FFL in all four infants. Two patients were treated with endoscopic cyst excision. One case underwent endoscopic cyst excision and supraglottoplasty, while the other was followed without surgery. All surgeries were successful, as none of the patients experienced recurrence. Conclusion: Although congenital VCs are extremely rare, they should be considered among the differential diagnosis of congenital stridor. A detailed examination with FFL should be performed for diagnosis. Based on our findings, transoral endoscopic excision of VCs is a safe, effective, and feasible procedure as a surgical treatment to prevent recurrence.

Anahtar Kelimeler

Congenital, cyst excision, infant, vallecular cys

Kaynakça

• Raftopulos M, Soma M, Lowinger D, Eisman P. Vallecular cysts: a differential diagnosis to consider for neonatal stridor and failure to thrive. JRSM Short Rep 2013;4:29.
• Romak JJ, Olsen SM, Koch CA, Ekbom DC. Bilateral vallecular cysts as a cause of Dysphagia: case report and literature review. Int J Otolaryngol 2010;2010:697583.
• Khashu M, Osiovich H, Kozak F, Pelligra G, Hirsh D, Smyth J. Congenital epiglottic cyst presenting with severe airway obstruction at birth. J Perinatol 2006;26:71-2.
• Oelsen JM, Hewett KM, Discolo CM, Jackson BF. Congenital Vallecular Cyst as a Cause of Neonatal Stridor and Apnea. Pediatr Emerg Care 2018;34:e152-e154.
• Li Y, Irace AL, Dombrowski ND, Perez-Atayde AR, Robson CD, Rahbar R. Vallecular cyst in the pediatric population: Evaluation and management. Int J Pediatr Otorhinolaryngol 2018;113:198-203.
• Tuncer U, Aydoğan LB, Soylu L. Vallecular cyst: a cause of failure to thrive in an infant. Int J Pediatr Otorhinolaryngol 2002;65:133-5.
• Yao TC, Chiu CY, Wu KC, Wu LJ, Huang JL. Failure to thrive caused by the coexistence of vallecular cyst, laryngomalacia and gastroesophageal reflux in an infant. Int J Pediatr Otorhinolaryngol 2004;68:1459-64.
• Gogia S, Agarwal SK, Agarwal A. Vallecular cyst in neonates: case series-a clinicosurgical insight. Case Rep Otolaryngol 2014;2014:764860.
• Prowse S, Knight L. Congenital cysts of the infant larynx. Int J Pediatr Otorhinolaryngol 2012;76:708-11.
• Cheng SS, Forte V, Shah VS. Symptomatic congenital vallecular cyst in a neonate. J Pediatr 2009;155:446.
• Tsai YT, Lee LA, Fang TJ, Li HY. Treatment of vallecular cysts in infants with and without coexisting laryngomalacia using endoscopic laser marsupialization: fifteen-year experience at a single- center. Int J Pediatr Otorhinolaryngol 2013;77:424-8.
• Wong KS, Li HY, Huang TS. Vallecular cyst synchronous with laryngomalacia: presentation of two cases. Otolaryngol Head Neck Surg 1995;113:621-4.
• McClurg FL, Evans DA. Laser laryngoplasty for laryngomalacia. Laryngoscope 1994;104:247-52.
• Snyder EJ, Zhang W, Jasmin KC, Thankachan S, Donnelly LF. Gauging potential risk for patients in pediatric radiology by review of over 2,000 incident reports. Pediatr Radiol 2018;48:1867-74.
• Hsieh WS, Yang PH, Wong KS, Li HY, Wang ECR, Yeh TF. Vallecular cyst: An uncommon cause of stridor in newborn infants. Eur J Pediatr 2000;159:79-81.
• Leibowitz JM, Smith LP, Cohen MA, Dunham BP, Guttenberg M, Elden LM. Diagnosis and treatment of pediatric vallecular cysts and pseudocysts. Int J Pediatr Otorhinolaryngol 2011;75:899-904.
• Ku AS. Vallecular cyst: report of four cases--one with co-existing laryngomalacia. J Laryngol Otol 2000;114:224-6.
• Gutiérrez JP, Berkowitz RG, Robertson CF. Vallecular cysts in newborns and young infants. Pediatr Pulmonol 1999;27:282-5.