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Congenital Laryngeal Cyst

Larynx Anomaly


Presentation

  • Here, we present an interesting clinical case. We also concisely reviewed the literature on the epidemiology, clinical presentation, diagnosis, classification, and therapy for laryngeal cysts.[ncbi.nlm.nih.gov]
  • This is a rare condition in newborns that must be considered in infants presenting with stridor, tachypnea, and difficulty with breastfeeding. About 50% of cases are asymptomatic, but it can present as acute respiratory distress at birth.[arquivosdeorl.org.br]
  • The treatment of the cyst is total surgical excision.This article reviews the literature and presents acase of congenital laryngeal cyst that caused respiratorydistress at birth and was treated surgically.Key words: Larynx, cyst, congenital, newborn,[ingentaconnect.com]
Surgical Procedure
  • (Authors include clinical presentation, imaging, and surgical procedures.) Walshe, C. “Vallecular cyst causing a difficult intubation”.[thecardiologyadvisor.com]
  • Surgical procedures for congenital laryngeal cysts include endoscopic excision, deroofing, laryngofissure and lateral pharyngotomy. 7 Marsupialization is a definitive procedure for epiglottic cysts and may be performed with carbon dioxide laser, electrocautery[nature.com]
  • Some of the surgical procedures we offer include: Vocal cord injection, a procedure done under anesthesia that involves injecting a substance into the vocal cord to help it approximate to the opposite side.[mottchildren.org]
  • Having secured the airway with orotracheal intubation, the surgical procedure consisted of an incision in the cyst lining with CO 2 laser, dissection to its base in the orifice of the saccule using microforceps and subsequent removal of the saccule.[elsevier.es]
  • Middlebrooks, Mehmet Senoglu Ventriculoperitoneal shunt (VPS) placement is an effective and most frequently used surgical method in the treatment of hydrocephalus, but the mechanical and infective complications are often seen after this surgical procedure[jcpsp.pk]
Anemia
  • Stay current on the developments and research surrounding neonatal anemia from the entirely new chapter on Blood and Hematopoietic System highlights.[books.google.com]
  • […] differentiated from multilocular thymic cyst, as the latter represents an acquired, multilocular, inflammatory lesion arising from cystic dilatation of the medullary duct and having an association with autoimmune diseases, such as Sjogren’s syndrome and aplastic anemia[appliedradiology.com]
Stridor
  • They often cause chronic hoarseness and severe stridor. Case reports of congenital laryngeal cyst complicated with pneumothorax and pneumomediastinum are very rare.[ncbi.nlm.nih.gov]
  • A change in head position can modify the stridor pattern, and this may be a diagnostic clue. Early stridor detection is essential, and the clinical evaluation with endoscopy is the main investigational approach. Surgical treatment is performed.[arquivosdeorl.org.br]
  • Keywords Congenital malformation; Stridor; Pediatric airway; Laser surgery; Laryngeal cyst Introduction Laryngomalacia is the most common cause of stridor in the newborn, accounting for 75% of the cases [ 1 ].[omicsonline.org]
Respiratory Distress
  • About 50% of cases are asymptomatic, but it can present as acute respiratory distress at birth. A change in head position can modify the stridor pattern, and this may be a diagnostic clue.[arquivosdeorl.org.br]
  • Therefore, a congenital laryngealcyst should be considered in the differential diagnosis ofan infant who develops respiratory distress and stridor.Flexible nasopharyngolaryngoscop is a valuable tool indiagnosis.[ingentaconnect.com]
  • When it occurs in neonates and is associated with respiratory distress, it must be treated urgently.[revistas.unal.edu.co]
  • CT or MRI may be difficult and even hazardous due to the respiratory distress and in our case the quality of the scan was too poor to be of any value.[omicsonline.org]
  • Respiratory distress and cyanosis are rare.[emedicine.medscape.com]
Cyanosis
  • The leading symptoms, inspiratoric stridor, cyanosis, and jugular and epigastric retractions, are caused by blockage of the airway.[ncbi.nlm.nih.gov]
  • The symptoms which also may include hoarseness, cyanosis and feeding problems, usually appear the first day, but may be delayed up to several weeks or even years [ 3 ]. The upper airway obstruction caused by the cyst can be potentially lethal.[omicsonline.org]
  • Signs of airway resistance: nasal flaring, intercostal / subcostal / supraclavicular recession, cyanosis 75 Physical Examination 3. Associated fever: inflammatory cause 4.[slideplayer.com]
  • Apart from acute life threatening airway obstruction, presenting symptoms include stridor, feeding problems, chest retractions, apnea, cyanosis, failure to thrive and hoarse cry.[nature.com]
  • At one week of age the child had inspiratory stridor that was worse with feeding and caused some cyanosis, which abated with cessation of the feeds.[thejhs.org]
Cesarean Section
  • Case Presentation Full-term newborn patient with adequate weight for gestational age, delivered via cesarean section and with polyhydramnios and APGAR 10/10.[revistas.unal.edu.co]

Treatment

  • Nevertheless, delayed diagnosis and treatment can cause life-threatening airway obstruction. Even though the diagnosis is easily made by careful inspection, treatment results often in recurrence.[ncbi.nlm.nih.gov]
  • This underlines the importance of a swift, correct diagnosis and a proper treatment.[omicsonline.org]
  • Its definitive treatment is surgical according to the literature.[revistas.unal.edu.co]
  • The treatment of the cyst is total surgical excision.This article reviews the literature and presents acase of congenital laryngeal cyst that caused respiratorydistress at birth and was treated surgically.Key words: Larynx, cyst, congenital, newborn,[ingentaconnect.com]

Prognosis

  • The prognosis and outcome is usually excellent and we will not advocate postoperative CT/MRI or an endoscopy control at this stage, if the infant is thriving and shows a normal development. “The proof of the pudding is in the eating!”[omicsonline.org]
  • CT Well-defined, fluid-attenuation, non-enhancing rounded lesion MRI Well-defined, fluid signal intensity, non-enhancing rounded lesion Treatment and prognosis Different forms of treatment have been described for laryngeal cysts, such as aspiration, marsupialisation[radiopaedia.org]
  • The prognosis for individuals with this disorder is poor.[emedicine.medscape.com]

Etiology

  • Vishal Sharma 2 Epidemiology 80 – 85 % children 3 yrs with stridor have congenital etiology for stridor 60 % of these anomalies are in larynx 20-25 % are anomalies of trachea bronchi 45% patients have more than 1 anomalies 3 Etiology Supraglottis: Laryngomalacia[slideplayer.com]
  • Etiology Although there is no consensus as to the etiology of laryngomalacia, several theories have been proposed.[entokey.com]
  • A less common etiology of stridor and respiratory distress in newborns and infants is congenital laryngeal saccular cyst. This entity should be considered in the differential diagnosis of stridor.[semanticscholar.org]
  • Etiology and pathogenesis Lymphangiomas originate from lymphatic vessel malformations.[emedicine.medscape.com]
  • (Discusses etiology and transhyoid surgical approach.) Mahajan, V. “Vallecular cyst-revisited”. Indian J Pediatr. vol. 75. 2008. pp. 1081-82.[thecardiologyadvisor.com]

Epidemiology

  • We also concisely reviewed the literature on the epidemiology, clinical presentation, diagnosis, classification, and therapy for laryngeal cysts.[ncbi.nlm.nih.gov]
  • Congenital Laryngeal Webs Epidemiology Laryngeal webs are rare congenital anomalies of the larynx.[emedicine.medscape.com]
  • Epidemiology [ edit ] Congenital cysts of the larynx with incidence of about 1.8 in 100,000 newborns. [1] Laryngeal cysts form 4% of all laryngeal tumors [6] or about 5% of benign laryngeal lesions. [10] Prevalence is about equal between the sexes. [11[en.wikipedia.org]
  • Vishal Sharma 2 Epidemiology 80 – 85 % children 3 yrs with stridor have congenital etiology for stridor 60 % of these anomalies are in larynx 20-25 % are anomalies of trachea bronchi 45% patients have more than 1 anomalies 3 Etiology Supraglottis: Laryngomalacia[slideplayer.com]
Sex distribution
Age distribution

Pathophysiology

  • […] commonly involve the cisterna chyli, followed by the mediastinum and rarely involve the neck. 87 Cervical thoracic duct lymphoceles are rarely congenital, more commonly arising secondary to thoracic duct injury after neck dissection or trauma. 88 The exact pathophysiologic[appliedradiology.com]

Prevention

  • FRED (fog reduction elimination device); used to defog the telecscopes used in imaging the larynx; FRED is variable in effectiveness to prevent fogging; HH's preference: use hot water to warm the tip of the telescope to prevent fogging Kenalog 40 mixed[medicine.uiowa.edu]
  • […] prolonged intubation which limits the amount of airflow available to help generate the voice Congenital or acquired laryngeal webs / vocal cord webs / glottic webs and subglottic webs – a band of tissue between the vocal cords or in the larynx that prevents[mottchildren.org]
  • Use of CO 2 laser is justified as it facilitates removal of the cyst, prevents edema, and recurrence.[laryngologyandvoice.org]
  • To prevent future infections, doctors usually recommend surgery to remove the cyst. A surgeon will usually perform the surgery on an outpatient basis. This means your child can go home the same day. Your child will also be under general anesthesia.[healthline.com]
  • Supportive measures are also necessary for the patient with bilateral vocal fold paralysis to ensure that adequate nutrition is received while preventing aspiration.[emedicine.medscape.com]

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