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Subglottic cysts in the premature infant.

J D Smith1, R Cotton, C M Meyer

  • 1Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University, Portland.

Archives of Otolaryngology--Head & Neck Surgery
|April 1, 1990
PubMed
Summary

Subglottic cysts, rarely reported in newborns, can cause acquired subglottic stenosis after prolonged intubation. Endoscopic marsupialization is a recommended conservative treatment for these cysts.

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Area of Science:

  • Pediatric Otolaryngology
  • Neonatal Intensive Care
  • Airway Management

Background:

  • Supraglottic cysts are common in newborns, but subglottic cysts are infrequently reported.
  • Prolonged intubation in the neonatal intensive care unit is a potential risk factor for subglottic pathology.

Observation:

  • Nine neonates with prolonged intubation developed acquired subglottic stenosis.
  • Stenosis presented as progressive biphasic stridor weeks to months after extubation.
  • Endoscopy revealed irregular subglottic stenosis with smooth mucosal lining, often with apparent cysts.

Findings:

  • Subglottic cysts were identified in nine neonates with acquired subglottic stenosis.
  • Six patients were successfully treated with endoscopic marsupialization, diathermy, or laser ablation.
  • Two patients initially treated for stenosis required tracheostomy before cyst recognition during laryngotracheoplasty.

Implications:

  • Subglottic cysts should be considered in neonates with acquired subglottic stenosis post-intubation.
  • Conservative endoscopic management, particularly marsupialization, is effective for subglottic cysts.
  • Early recognition and conservative treatment can prevent the need for tracheostomy.

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