Subglottic cysts: The Great Ormond Street experience in 105 patients

Area of Science:

• Pediatric Otolaryngology
• Laryngology
• Pediatric Airway Surgery

Background:

• Subglottic cysts (SGCs) are uncommon congenital or acquired lesions.
• They can cause significant upper airway obstruction in infants and children.
• A history of prematurity and intubation is a common risk factor.

Purpose of the Study:

• To evaluate the current presentation and management strategies for subglottic cysts.
• To provide evidence-based recommendations for treating patients with SGCs.
• To analyze recurrence rates and associated airway pathologies.

Main Methods:

• Retrospective case series.
• 105 patients treated between October 1999 and November 2017.
• Data collected on patient history, symptoms, interventions, and outcomes.

Main Results:

• 91% of patients were premature (mean gestation 27.2 weeks); 99% had a history of intubation.
• Stridor was the most common presenting symptom (57.1%).
• Surgical marsupialization (86%) and CO2 laser (14%) were used for treatment; recurrence occurred in 56% of cases.
• 47% had concurrent subglottic stenosis; 16% required further reconstructive surgery.

Conclusions:

• SGCs are a reversible cause of upper airway obstruction, particularly in premature infants with intubation history.
• Surgical marsupialization is the recommended treatment.
• High rates of recurrence and concurrent subglottic stenosis necessitate expert management and long-term follow-up.