Evaluation of pediatric subglottic cysts.

Area of Science:

• Pediatric Otolaryngology
• Pediatric Surgery
• Respiratory Medicine

Background:

• Subglottic cysts (SGCs) are increasingly recognized as a cause of upper airway obstruction in infants, particularly those with a history of intubation.
• Standard treatment involves endoscopic marsupialization using cold steel instruments or CO2 laser.

Purpose of the Study:

• To present a case series of infants treated for subglottic cysts (SGCs).
• To evaluate the efficacy of endoscopic marsupialization combined with mechanical decompression via balloon dilatation for SGC treatment.

Main Methods:

• Retrospective study of 9 infants diagnosed with SGCs between 2003 and 2010.
• Diagnosis was confirmed via flexible nasopharyngolaryngoscopy.
• Surgical treatment involved endoscopic marsupialization (cold steel or CO2 laser) and balloon dilatation.

Main Results:

• Patients ranged from 3 to 36 months old; 7 were male.
• Three patients had a history of intubation (6-28 days).
• Cysts were multiple, located posteriorly/laterally in the subglottic area/upper trachea, presenting with stridor, failure to thrive, and recurrent croup. No recurrence was noted in 8 months to 3 years of follow-up.

Conclusions:

• Diagnostic laryngoscopy and bronchoscopy are crucial for SGC diagnosis.
• SGCs can be congenital, not solely associated with prematurity or intubation.
• Airway evaluation is essential for infants with persistent stridor or hoarseness, mimicking chronic obstructive lung disease symptoms.