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Bronchogenic cyst with tracheal involvement.

H M Yerman1, L D Holinger

  • 1Department of Otolaryngology-Head & Neck Surgery, University of Illinois College of Medicine, Chicago.

The Annals of Otology, Rhinology, and Laryngology
|February 1, 1990
PubMed
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Bronchogenic cysts in infants can cause airway obstruction. Endoscopic aspiration of these cysts, while potentially relieving symptoms, carries risks like severe bradycardia due to vagal nerve proximity.

Area of Science:

  • Pediatric Surgery
  • Developmental Biology
  • Respiratory Medicine

Background:

  • Bronchogenic cysts are rare congenital anomalies originating from the primitive foregut.
  • These cysts can lead to significant ventilatory compromise in infants and children.
  • Symptoms include stridor and obstructive apnea due to airway compression.

Observation:

  • A 2-month-old infant presented with stridor and apnea caused by a tracheal bronchogenic cyst.
  • Endoscopic cyst aspiration during bronchoscopy led to severe bradycardia (140 to 50 bpm).
  • Blood pressure remained stable with 100% oxygen saturation during the event.

Findings:

  • The bronchogenic cyst was closely associated with the vagus nerve.
  • Vagal stimulation during aspiration is the suspected cause of the bradycardia.

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  • Surgical intervention (thoracotomy) was ultimately required.

    • Implications:

    • Bronchogenic cysts should be considered in the differential diagnosis of neonatal airway obstruction.
    • Endoscopic aspiration of such cysts is not without risk and may not replace surgical treatment.
    • Awareness of potential vagal nerve involvement is crucial during procedures on these lesions.