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Cai H, Gao J. Low-Temperature Plasma Radiofrequency Ablation for Congenital Epiglottic Cysts. EAR, NOSE & THROAT JOURNAL 2024:1455613241259368. [PMID: 38828889 DOI: 10.1177/01455613241259368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
Objectives: Congenital epiglottic cysts are rare disorders of the larynx with symptoms such as laryngeal stridor and inspiratory dyspnea and are life-threatening in severe cases. This study aimed to investigate the usefulness of low-temperature plasma radiofrequency ablation for congenital epiglottic cysts and provide a reference for clinicians to develop treatment options. Methods: The clinical data of children (n = 7, 4 males and 3 females) with congenital epiglottic cysts, who were admitted to the Second Affiliated Hospital of Wenzhou Medical University and Yuying Children's Hospital from March 2018 to March 2023, were analyzed retrospectively. Following preoperative examinations, all patients underwent low-temperature plasma radiofrequency ablation under general anesthesia, and the curative effect was evaluated. Following surgery, regular patient follow-up examinations were conducted to monitor recurrence. Results: The age at the time of operation ranged from 1 day to 99 days, with an average of 37.57 ± 35.01 days. The surgical procedure was successfully completed in all the children; dyspnea disappeared and no surgical complications were observed. In addition, during the postoperative follow-up period of 6 months to 5 years, recurrence was not observed. Conclusions: Low-temperature plasma radiofrequency ablation is a safe and effective procedure for treating congenital epiglottic cysts and deserves clinical application and promotion.
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Affiliation(s)
- Hao Cai
- Department of Otorhinolaryngology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jinjian Gao
- Department of Otorhinolaryngology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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2
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Rao S, Zameer MM, C V, D’Cruz A. Laryngeal Cyst in Children : A Retrospective Analysis. Indian J Otolaryngol Head Neck Surg 2023; 75:1352-1355. [PMID: 37636804 PMCID: PMC10447707 DOI: 10.1007/s12070-023-03495-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 01/16/2023] [Indexed: 02/19/2023] Open
Abstract
Aim: To study the presentation, management and outcome of laryngeal cysts in children. Materials and methods: This is a retrospective observational study of children with Laryngeal cysts who were managed in the Department of Paediatric Surgery between April 2015 to Jan 2022. Observations and Results: Eight children with laryngeal cysts were included, 5 were girls. Age ranged from 3 days to 10 years (median 5 months). Weight ranged from 3kg to 40kg (median 6.3 kg). All presented with stridor. Three children had co-morbid conditions, one each with Leucocyte adhesion deficiency type -1, atrial septal defect & PHACES syndrome. Two children had severe respiratory distress and required tracheostomy at presentation. All children underwent MLB. The cysts were 2 subglottic cysts (one inflammatory cyst) and 6 vallecular cyst. Five underwent endoscopic excision of cysts, 1 underwent excision with lateral cervical approach, 1 underwent endoscopic de-roofing of cyst and airway reconstruction with anterior costal cartilage graft (associated Sub glottis stenosis). Conclusion: Laryngeal cysts are a rare cause of stridor in children. MLB is the best diagnostic tool. Treatment with excision / deroofing of the cyst endoscopically, is safe and effective in paediatric age group. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03495-w.
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Affiliation(s)
- Sanjay Rao
- Narayana Health City, 258/A, Bommasandra Industrial Area Hosur Road, 560099 Bangalore, Karnataka India
| | - M M Zameer
- Narayana Health City, 258/A, Bommasandra Industrial Area Hosur Road, 560099 Bangalore, Karnataka India
| | - Vinay C
- Narayana Health City, 258/A, Bommasandra Industrial Area Hosur Road, 560099 Bangalore, Karnataka India
| | - Ashley D’Cruz
- Narayana Health City, 258/A, Bommasandra Industrial Area Hosur Road, 560099 Bangalore, Karnataka India
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3
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Shumrick CM, Calder AN, Vecchiotti MA, Scott AR. Symptomatic Lingual Thyroglossal Duct Cyst in Children: A Laryngomalacia Phenotype. Ann Otol Rhinol Laryngol 2022; 132:95-99. [PMID: 35100842 DOI: 10.1177/00034894221075082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Patients with lingual thyroglossal duct cyst (TGDC) can present as symptomatic with obstructive airway and feeding difficulties. METHODS We present 3 cases of symptomatic lingual TGDC. RESULTS All 3 patients were diagnosed with laryngomalacia and underwent further concurrent or delayed airway intervention, in addition to cyst removal. CONCLUSIONS We reason that there is a phenotype of laryngomalacia in the symptomatic lingual thyroglossal duct cyst patients who present with symptoms due to disruption in laryngeal anatomy rather than the cyst itself causing obstructive symptoms. Distinguishing this phenotype, especially in comparison to other pathologies such as vallecular cysts, may better allow for planning of concurrent or delayed airway procedures and overall counseling of parents.
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Affiliation(s)
| | - Alyssa N Calder
- Tufts University School of Medicine, Boston, MA, USA.,Drexel University College of Medicine, Philadelphia, PA, USA
| | - Mark A Vecchiotti
- Department of Otolaryngology-Head & Neck Surgery, Tufts Medical Center, Boston, MA, USA.,Tufts University School of Medicine, Boston, MA, USA.,Divisions of Pediatric Otolaryngology and Facial Plastic Surgery, Department of Otolaryngology-Head & Neck Surgery, Tufts Children's Hospital, Boston, MA, USA
| | - Andrew R Scott
- Department of Otolaryngology-Head & Neck Surgery, Tufts Medical Center, Boston, MA, USA.,Tufts University School of Medicine, Boston, MA, USA.,Divisions of Pediatric Otolaryngology and Facial Plastic Surgery, Department of Otolaryngology-Head & Neck Surgery, Tufts Children's Hospital, Boston, MA, USA
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4
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Alnaimi A, Abushahin A. Vallecular Cyst: Reminder of a Rare Cause of Stridor and Failure to Thrive in Infants. Cureus 2021; 13:e19692. [PMID: 34934567 PMCID: PMC8684262 DOI: 10.7759/cureus.19692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 11/05/2022] Open
Abstract
The vallecular cyst is a rare cause of stridor, respiratory distress, and failure to thrive in infants. Large vallecular cysts may present with serious complications such as life-threatening airway obstruction. This report is of an infant who presented with stridor and failure to thrive. The patient’s condition was diagnosed as the presence of a vallecular cyst using flexible laryngoscopy. The vallecular cyst was successfully managed using endoscopic marsupialization. After the procedure, the patient was asymptomatic and dramatically gained weight within a few months. This case report serves as a reminder for clinicians to consider vallecular cysts as a differential diagnosis of stridor and failure to thrive in infants. It also emphasizes that early diagnosis and management lead to favorable clinical outcomes.
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Affiliation(s)
- Amal Alnaimi
- Pediatric Pulmonology, Sidra Medicine, Doha, QAT
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5
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Archana M, Segaran S, Zachariah M, George SK. Infant with stridor due to vallecular cyst - Anaesthetic management. Indian J Anaesth 2021; 65:340-342. [PMID: 34103753 PMCID: PMC8174601 DOI: 10.4103/ija.ija_1394_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/14/2021] [Accepted: 02/11/2021] [Indexed: 12/26/2022] Open
Affiliation(s)
- Mohankumar Archana
- Department of Anaesthesia, Pondicherry Institute of Medical Sciences, Pondicherry, India
| | - Sivakumar Segaran
- Department of Anaesthesia, Pondicherry Institute of Medical Sciences, Pondicherry, India
| | - Mamie Zachariah
- Department of Anaesthesia, Pondicherry Institute of Medical Sciences, Pondicherry, India
| | - Sagiev Koshy George
- Department of Anaesthesia, Pondicherry Institute of Medical Sciences, Pondicherry, India
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6
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Congenital vallecular cyst causing severe inspiratory stridor in a newborn. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2020. [DOI: 10.1016/j.epsc.2020.101460] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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7
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Wang GX, Zhang FZ, Zhao J, Wang H, Li HB, Wang XM, Zhang J, Ni X. Minimally invasive procedure for diagnosis and treatment of vallecular cysts in children: review of 156 cases. Eur Arch Otorhinolaryngol 2020; 277:3407-3414. [PMID: 32621247 DOI: 10.1007/s00405-020-06163-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/20/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Vallecular cyst is an uncommon but potentially life-threatening disease. The aim of this study was to review the presentation, evaluation, and treatment of vallecular cysts in children. METHODS Medical records of 156 patients treated for vallecular cysts between 2013 and 2016 were retrospectively reviewed. The patients were divided into four age groups for comparison of clinical data: A, < 1 month; B, 1-6 months; C, 7-12 months; and D, > 1 year. RESULTS The median age of all patients (98 males and 58 females) was 12.1 months (range 1 day-11 years), including 21, 86, 21, and 28 patients in group A, B, C, and D, respectively. A diagnosis of vallecular cysts was made for 135 patients using a combination of flexible laryngoscopy and ultrasound, and ten patients (all in group A) required pre-surgery ventilation support. The most common symptoms were wheezing (59.6%) and stridor (36.5%). Ten patients experienced difficulty with intubation. Endoscopic-assisted transoral coblation marsupialization was performed for all patients, combined with supraglottoplasty for 41 out of 68 patients with concurrent laryngomalacia. Patients in group D had a longer operation time and higher incidence of intraoperative bleeding, two of whom experienced post-operation recurrence, and symptoms resolved after a second operation in both cases. CONCLUSIONS Flexible laryngoscopy and ultrasound are recommended for a diagnosis in suspected cases of vallecular cysts. Coblation marsupialization has advantages of minor damage, low recurrence rate, and suitability for all age groups.
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Affiliation(s)
- Gui-Xiang Wang
- Department of Otolaryngology, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China
| | - Feng-Zhen Zhang
- Department of Otolaryngology, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China
| | - Jing Zhao
- Department of Otolaryngology, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China
| | - Hua Wang
- Department of Otolaryngology, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China
| | - Hong-Bin Li
- Department of Otolaryngology, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China
| | - Xiao-Man Wang
- Department of Ultrasound, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China
| | - Jie Zhang
- Department of Otolaryngology, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China.
| | - Xin Ni
- Department of Otolaryngology, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China.
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8
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Delayed diagnosis of an infected vallecular cyst in an infant. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2018.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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9
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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. [PMID: 30173985 DOI: 10.1016/j.ijporl.2018.07.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/20/2018] [Accepted: 07/21/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To review the presentation of pediatric vallecular cysts and outline an approach for evaluation and management. METHODS Medical records of patients diagnosed with vallecular cyst between 2005 and 2017 were reviewed. Data on demographics, clinical characteristics, diagnostic methods, surgical procedures, and outcomes were collected and analyzed. A comprehensive literature search for pediatric cases of vallecular cyst was conducted for comparative analysis. RESULTS Twenty patients underwent surgery for congenital vallecular cysts during the study period. Age at diagnosis ranged from birth to 8 years (median age = 1.1 years). The most common preoperative symptom was inspiratory stridor (45%) followed by feeding difficulties (40%). Eight patients (40%) initially presented with laryngomalacia and 7 (35%) with feeding difficulties. Imaging was obtained in 16 patients and consisted of plain films, ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI). Marsupialization of the cyst was performed in all 20 patients. Three patients (15%) presented with recurrence. CONCLUSION Vallecular cysts can cause feeding difficulties due to upper airway obstruction and pressure at the laryngeal inlet. Diagnostic work-up for vallecular cysts should include a detailed medical history, complete head and neck examination including endoscopic examination, and appropriate imaging, as each of these components complements the histopathologic findings. Our findings indicate that performing marsupialization is associated with low rate of recurrence or complication.
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Affiliation(s)
- Youjin Li
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA 02115, USA
| | - Alexandria L Irace
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA 02115, USA
| | - Natasha D Dombrowski
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA 02115, USA
| | - Antonio R Perez-Atayde
- Department of Pathology, Boston Children's Hospital, Boston, MA 02115, USA; Department of Pathology, Harvard Medical School, Boston, MA 02115, USA
| | - Caroline D Robson
- Department of Radiology, Boston Children's Hospital, Boston, MA, 02115, USA; Department of Radiology, Harvard Medical School, Boston, MA 02115, USA
| | - Reza Rahbar
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA 02115, USA; Department of Otolaryngology, Harvard Medical School, Boston, MA 02115, USA.
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10
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Rigid endoscope-assisted orotracheal intubation for vallecular cyst surgery in neonates and young infants. Int J Pediatr Otorhinolaryngol 2018; 110:61-66. [PMID: 29859590 DOI: 10.1016/j.ijporl.2018.04.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 04/16/2018] [Accepted: 04/19/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To investigate the outcomes of rigid endoscope-assisted orotracheal intubation (REI) in neonates and young infants with difficult airway conditions as an alternative intubation technique when more specific airway instruments are not available in most developing countries, and to evaluate the safety and advantages of this method. METHODS Neonatal and young infantile patients undergoing vallecular cyst surgery with a Cormack-Lehane Grade 3 or 4 glottic view between June 2013 and June 2015 were studied. Fifteen patients were intubated using rigid endoscopic assistance. Fifteen other patients who were intubated using the conventional technique were selected from the previous consecutive cases and used as a matched control group. RESULTS REI was successfully performed in all 15 patients in one intubation attempt. The anesthetic preparation duration for the REI group was 6 min (interquartile range 5-7 min), which was shorter than the anesthetic preparation duration for patients intubated using the conventional technique (15 min [interquartile range 10-20 min], p < 0.001). The time required for intubation with a rigid endoscope was 66.5 s (interquartile range 58-74 s). No volume reduction of cysts or tracheotomies was needed in the REI group, and no cysts were ruptured nor did laryngeal mucosa damage occur with this technique. Among patients of conventional group, one required a tracheotomy, and four required cyst volume reduction by needle aspiration. No residual lesions or recurrence were observed during one year of postoperative follow-up in the REI group, and two recurrences were observed in the conventional group. CONCLUSION REI, which used common pieces of equipment in an otolaryngology operating room, may be a safe and feasible alternative for intubation in neonatal and young infantile patients with vallecular cysts or other difficult airway conditions.
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11
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Wang Z, Zhang Y, Ye Y, Yao W, Xu Z, Xia Z, Wang S, Zhou C. Clinical efficacy of low-temperature radiofrequency ablation of pharyngolaryngeal cyst in 84 Chinese infants. Medicine (Baltimore) 2017; 96:e8237. [PMID: 29095253 PMCID: PMC5682772 DOI: 10.1097/md.0000000000008237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The aim of the study is to investigate the advantages and disadvantages of low-temperature radiofrequency ablation of pharyngolaryngeal cyst.The study population was composed of 84 children diagnosed with pharyngolaryngeal cyst who underwent surgical treatment at the Department of Otolaryngology, Wuhan Children's Hospital, Wuhan, China, between January 1984 and December 2013. All patients were operated using a self-retaining laryngoscope and were divided into 3 groups: traditional cystectomy group (N = 9), dynamic cutting system group (N = 18), and low-temperature radiofrequency ablation group (N = 57). Clinical outcomes were analyzed to assess the efficacy of low-temperature radiofrequency ablation in treatment of pharyngolaryngeal cyst.Compared with traditional cystectomy group or dynamic cutting system group, operation time was shorter, bleeding was less and one-year recurrence rate was much lower in low-temperature radiofrequency ablation group. However, operation time and bleeding was not statistically different between traditional cystectomy and dynamic cutting system group.Low-temperature radiofrequency ablation may be an effective substitute for treating pharyngolaryngeal cyst.
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Affiliation(s)
- Zhinan Wang
- Department of Otolaryngology, Wuhan Pleiades ENT Hospital
- Department of Otolaryngology, Wuhan Children's Hospital, Wuhan
| | - Yamin Zhang
- Department of Otolaryngology, Wuhan Children's Hospital, Wuhan
| | - Yuhua Ye
- Department of Otolaryngology, Wuhan Children's Hospital, Wuhan
| | - Wei Yao
- Department of Otolaryngology, Wuhan Children's Hospital, Wuhan
| | - Zhongqiang Xu
- Department of Otolaryngology, Wuhan Children's Hospital, Wuhan
| | - Zhongfang Xia
- Department of Otolaryngology, Wuhan Children's Hospital, Wuhan
| | - Shufen Wang
- Department of Otolaryngology, Wuhan Children's Hospital, Wuhan
| | - Chengyong Zhou
- Department of Otolaryngology, First Affiliated Hospital of PLA General Hospital, China
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12
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Cadena E, Guerra R, Pérez-Mitchell C. Bilateral vallecular cyst: transoral robotic resection. J Robot Surg 2017; 12:369-372. [PMID: 28785853 DOI: 10.1007/s11701-017-0733-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 08/01/2017] [Indexed: 10/19/2022]
Abstract
Vallecular cyst is more frequent in neonatal life, but could be present in adults. Frequently it is asymptomatic although some people has foreign body sensation upon swallowing and obstructive problems to sleep. The best treatment for these cases is complete resection, as recurrence is usual with any cyst remnant wall causing re-accumulation. We present the case of a patient with symptomatic vallecular cyst treated with transoral robotic surgery. The technique confirmed the advantages related with tridimensional vision close to the cyst, associated with multi-articulated 5 mm EndoWrist® instruments that made real safe and efficient surgery.
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Affiliation(s)
- Enrique Cadena
- Department of Otorhinolaryngology and Head and Neck, Clínica Marly, Bogotá, Colombia. .,Department of Otorhinolaryngology, Universidad Nacional de Colombia, Bogotá, Colombia. .,Department of Head and Neck, Instituto Nacional de Cancerología, Bogotá, Colombia. .,, Calle 91 # 19C-62 Cons. 706, Bogotá, Colombia.
| | - Ricardo Guerra
- Department of Otorhinolaryngology and Head and Neck, Clínica Marly, Bogotá, Colombia.,Department of Otorhinolaryngology, Section of Laryngology, Hospital Universitario Infantil de San José, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
| | - Carlos Pérez-Mitchell
- Cranial Base, Head and Neck Institute, Hospital HIMA San Pablo, Caguas, Puerto Rico.,Department of Otolaryngology, Head and Neck Surgery, Universidad de Puerto Rico Recinto de Ciencias Medicas, San Juan, Puerto Rico
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13
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Heyes R, Lott DG. Laryngeal Cysts in Adults: Simplifying Classification and Management. Otolaryngol Head Neck Surg 2017; 157:928-939. [DOI: 10.1177/0194599817715613] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective Laryngeal cysts may occur at any mucosa-lined location within the larynx and account for 5% to 10% of nonmalignant laryngeal lesions. A number of proposed classifications for laryngeal cysts exist; however, no previously published classification aims to guide management. This review analyzes contemporary laryngeal cyst management and proposes a framework for the terminology and management of cystic lesions in the larynx. Data Sources PubMed/Medline. Review Methods A primary literature search of the entire Medline database was performed for all titles of publications pertaining to laryngeal cysts and reviewed for relevance. Full manuscripts were reviewed per the relevance of their titles and abstracts, and selection into this review was according to their clinical and scientific relevance. Conclusion Laryngeal cysts have been associated with rapid-onset epiglottitis, dyspnea, stridor, and death; therefore, they should not be considered of little significance. Symptoms are varied and nonspecific. Laryngoscopy is the primary initial diagnostic tool. Cross-sectional imaging may be required, and future use of endolaryngeal ultrasound and optical coherence tomography may revolutionize practice. Where possible, cysts should be completely excised, and there is growing evidence that a transoral approach is superior to transcervical excision for nearly all cysts. Histology provides definitive diagnosis, and oncocytic cysts require close follow-up. Implications for Practice A new classification system is proposed that increases clarity in terminology, with the aim of better preparing surgeons and authors for future advances in the understanding and management of laryngeal cysts.
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Affiliation(s)
- Richard Heyes
- Department of Otorhinolaryngology–Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - David G. Lott
- Department of Otorhinolaryngology–Head and Neck Surgery, Mayo Clinic Arizona, Phoenix, Arizona, USA
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Marseglia L, D'Angelo G, Impellizzeri P, Salvo V, Catalano N, Bruno R, Galletti C, Galletti B, Galletti F, Gitto E. Neonatal stridor and laryngeal cyst: Which comes first? Pediatr Int 2017; 59:115-117. [PMID: 28102625 DOI: 10.1111/ped.13192] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 09/30/2016] [Accepted: 10/12/2016] [Indexed: 11/30/2022]
Abstract
Neonatal stridor is a rare condition usually caused by laryngomalacia. Congenital laryngeal cyst represents an uncommon cause of stridor in the neonatal population and may be misinterpreted as laryngomalacia, leading to serious morbidity and mortality if diagnosis and treatment are delayed. Herein we report the case of a full-term infant with stridor, feeding problems and failure to thrive. Initially, direct laryngoscopy diagnosed only laryngomalacia. As stridor worsened, however, and respiratory distress appeared, repeat laryngoscopy showed vallecular laryngeal cyst, visible macroscopically. The patient was successfully treated with endoscopic marsupialization. There was no evidence of recurrence at follow up after 3 months. This case highlights the importance of laryngoscopic assessment for suspected laryngeal abnormalities in infants with stridor. If symptoms worsen, endoscopy should be repeated, because congenital laryngeal cysts may not be immediately visible macroscopically.
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Affiliation(s)
- Lucia Marseglia
- Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy
| | - Gabriella D'Angelo
- Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy
| | - Pietro Impellizzeri
- Unit of Paediatric Surgery, Department of Paediatrics, University of Messina, Messina, Italy
| | - Vincenzo Salvo
- Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy
| | - Natalia Catalano
- Department of Otorhinolaryngology, University of Messina, Messina, Italy
| | - Rocco Bruno
- Department of Otorhinolaryngology, University of Messina, Messina, Italy
| | - Claudio Galletti
- Department of Anesthesiology and Critical Care, University of Messina, Messina, Italy
| | - Bruno Galletti
- Department of Otorhinolaryngology, University of Messina, Messina, Italy
| | - Francesco Galletti
- Department of Otorhinolaryngology, University of Messina, Messina, Italy
| | - Eloisa Gitto
- Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy
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15
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Congenital Vallecular Cyst Causing Airway Compromise in a 2-Month-Old Girl. Case Rep Med 2015; 2015:975859. [PMID: 26240568 PMCID: PMC4512577 DOI: 10.1155/2015/975859] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 06/22/2015] [Indexed: 11/28/2022] Open
Abstract
Congenital vallecular cyst is a rare entity and may present with acute airway obstruction. This is a case of congenital vallecular cyst presenting with airway compromise requiring immediate management. The epidemiology, pathogenesis, and clinical presentation of vallecular cysts are discussed as well as the diagnosis and management.
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16
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Chan LS, Daniel M, Boardman SJ, Cheng AT. Laryngotracheal stenosis and airway surgery--an outcomes based approach. Int J Pediatr Otorhinolaryngol 2014; 78:1931-6. [PMID: 25216809 DOI: 10.1016/j.ijporl.2014.08.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/16/2014] [Accepted: 08/18/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To review the outcomes of endoscopic, open or a combination of both surgical modalities for laryngotracheal stenosis and establish which factors influence results. METHODS Records of all children undergoing laryngotracheal procedures (excluding laryngomalacia and aspirated foreign bodies) by the Department of Otolaryngology at The Children's Hospital at Westmead between January 2003 and November 2011 were reviewed. Specific data on population, intervention, covariates and outcomes were recorded and analysed. RESULTS A total of 104 patients undergoing 277 procedures were included. 211 (76%) of the procedures were endoscopic, remaining 66 (24%) open. Patients undergoing open surgery were more likely to have significant co-morbidity, prior intubation, require ICU admission or tracheostomy and have a longer hospital stay. 57 (54.8%) patients were successfully treated with a single procedure (48 endoscopic and 9 open). Of the endoscopic patients requiring further surgery, 16 were managed with multiple endoscopic procedures, whilst 12 underwent subsequent open procedures. Open surgery was performed on 66 patients, 63.6% (42/66) of all open procedures required further endoscopic intervention and 45.2% (19/42) of these avoided further open surgery. CONCLUSIONS Both open and endoscopic surgery have a role in laryngotracheal stenosis, and many patients benefit from a combination of both. Ultimately the decision depends on experience of the treating team, social considerations, and institutional capabilities. A multi-centre prospective data collection would be a useful tool to further investigate optimal management approach.
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Affiliation(s)
- Lyndon S Chan
- The Children's Hospital at Westmead, Westmead, NSW, Australia.
| | - Matija Daniel
- The Children's Hospital at Westmead, Westmead, NSW, Australia; Nottingham University Hospitals, Nottingham, United Kingdom
| | | | - Alan T Cheng
- The Children's Hospital at Westmead, Westmead, NSW, Australia; University of Sydney, Discipline of Paediatrics and Child Health, Darlington, NSW, Australia
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