Epidermoid Cyst of the Uvula Causing Airway Compromise in a Neonate

Congenital uvular cysts are rare lesions in the pediatric population and are typically asymptomatic or discovered incidentally. Only a few cases have been associated with airway obstruction, and none have been reported in a newborn from the Saudi region. This report presents what we believe is the first documented case of a congenital uvular epidermoid cyst in a neonate presenting with airway compromise. We describe a male newborn, delivered at 36 + 5 weeks of gestation, who developed signs of cyanosis and desaturation shortly after birth. During anesthesia for emergent abdominal surgery, a large uvular mass was incidentally identified. Subsequent evaluation revealed a 2 × 7 cm cystic lesion involving the uvula. The patient underwent successful surgical excision of the mass. Histopathological analysis confirmed an epidermoid cyst. Postoperatively, the patient recovered well, with complete resolution of respiratory symptoms. This case underscores the importance of considering uvular cysts in the differential diagnosis of neonatal respiratory distress and highlights the need for awareness among clinicians.