Vallecular cyst: report of four cases - one with co-existing laryngomalacia

Abstract

Congenital vallecular cysts are rare. In this report, four infants having vallecular cysts encountered over a six-year period from 1992 to 1997 were reviewed. All of them presented with upper aerodigestive tract symptoms. Marsupialization was performed in three of them and CO2 laser excision was performed in the fourth patient. There was no recurrence of the cyst in any patient. One of them also had co-existing laryngomalacia. The degree of airway collapse caused by laryngomalacia improved after cyst removal. The laryngomalacia resolved spontaneously. Cyst fluid culture was performed in one of the patients and yielded Staphylococcus aureus but there was no other definite indicator of infection. Staphylococcus aureus could also be isolated in the respiratory tract from two of the other patients.

Diagnosis and treatment of pediatric vallecular cysts and pseudocysts

“…Clinically they present similarly and may rapidly enlarge if inflamed or infected. Only a small number of retrospective case series are found in the literature and most do not differentiate the pattern of recurrence that varies with respect to pathology [1][2][3][4][5][6][7]. In our series we reviewed our results to Table 1 Surgical approach and characterization of excision.…”

“…The most common means of diagnosis is to directly visualize the airway (most often using flexible NPL performed in an awake patient or, less often, rigid laryngoscopy/bronchoscopy performed in the operating room) [1][2][3]8]. Other authors have used barium esophagram, lateral neck X-rays, or MRI (T1 hypointense, T2 hyperintense, no enhancement with gadolinium) as initial diagnostic tools [4,5,7,9].…”

“…Concurrent LM and GERD have been reported to be present in patients with VC [3,4,6]. Liu et al reported a 91% (10/11) association of VC and LM [8] of which 4 patients required a laser supraglottoplasty.…”

“…Given the rarity of these lesions, the methods used to evaluate and to manage these patients varies in the literature. While most authors recommend flexible nasopharyngolaryngoscopy (NPL) for initial diagnostic evaluation [1,2] others have utilized lateral X-ray [1,3] and barium esophagram [4]. Treatment options include conservative medical management [2], cyst aspiration, marsupialization, surgical debulking, and laser excision [1][2][3].…”

Failure to thrive caused by the coexistence of vallecular cyst, laryngomalacia and gastroesophageal reflux in an infant

“…According to its location, the most common laryngeal cyst in infants is the aryepiglottic cyst, followed by the vallecular cyst [9]. There have very few reports of congenital vallecular cysts in the literature [1,[9][10][11][12][13][14][15][16]. Vallecular cysts were described as containing clear, nonpurulent fluid, and malignant transformation has not been reported [2].…”