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Management of pediatric subglottic cysts using the Bugbee fulgurating electrode
Matthew A Richardson1, Tyler W Winford2, Byron K Norris3
1Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson.
Insights
Subglottic cysts cause pediatric airway obstruction. Treatment with the Bugbee diathermy electrode effectively manages these cysts, significantly reducing recurrence rates compared to historical data.
Area of Science:
- Pediatric Otolaryngology
- Airway Management
- Congenital Anomalies
Background:
- Subglottic cysts are a significant cause of airway obstruction in children.
- Historical recurrence rates for subglottic cysts range widely from 12.5% to 71.0%.
Purpose of the Study:
- To describe the presentation and management of pediatric subglottic cysts.
- To evaluate the efficacy of the Bugbee fulgurating diathermy electrode for cyst treatment.
- To report recurrence rates associated with this treatment modality.
Main Methods:
- Retrospective review of 16 pediatric patients treated for subglottic cysts.
- Analysis of patient demographics, presenting symptoms, cyst characteristics, and treatment outcomes.
- Focus on outcomes using the Bugbee fulgurating diathermy electrode.
Main Results:
- The study included 16 patients with a mean gestational age of 26.9 weeks; all had prior intubations.
- Biphasic stridor was the most common symptom, presenting a mean of 7.3 months post-extubation.
- Symptomatic recurrence was low at 6%, with no major complications reported. Associated laryngeal pathology was present in 56% of patients.
Conclusions:
- The Bugbee fulgurating diathermy electrode offers a safe and effective treatment for subglottic cysts.
- This technique achieves a significantly lower symptomatic recurrence rate than previously reported.
- The findings support the use of this method for managing pediatric subglottic cysts.
Importance:
Subglottic cysts are an important cause of pediatric airway obstruction. We describe the typical presentation and management of subglottic cysts, with historical recurrence rates between 12.5% and 71.0%, and treatment using the Bugbee fulgurating diathermy electrode as a technique to successfully manage subglottic cysts with a low recurrence rate.
Observations:
A retrospective review was performed on 16 consecutive patients treated for subglottic cysts at a single tertiary-care facility. The mean gestational age was 26.9 weeks, with a male to female ratio of 4.3:1. All patients had at least 1 prior intubation, with a mean of 1.8 prior intubations per patient. Biphasic stridor was the most common presenting symptom, occurring at a mean of 7.3 months after the last extubation. At the time of diagnosis, patients were found to have a mean of 1.6 cysts, and the left lateral subglottic wall was the most common location of unilateral cysts. Nine patients (56%) had an associated laryngeal pathologic condition. Symptomatic cyst recurrence occurred in only 6% of patients, and no major complications were reported.
Conclusions And Relevance:
This review presents a treatment method for subglottic cysts that is safe and effective and has a symptomatic recurrence rate lower than previously reported.
