Laryngeal cyst and sudden death

Laryngeal cysts are relatively uncommon and account for about five per cent of benign laryngeal lesions. The commonest location is the epiglottis. Pathologically these lesions may be divided into epithelial, tonsillar or oncocytic types. The patients may be asymptomatic or present with hoarseness, dysphagia, cough or airway obstruction. Epithelial cysts of the larynx, although histologically benign, may produce sudden and unexpected death from asphyxia. A case is presented of a 32-year-old female who was sexually assaulted and later found dead. Death was most likely due to laryngeal obstruction caused by an epiglottic cyst. Alcohol intoxication (BAC = 0.25g%) is likely to have been a contributory factor. In this case the results of the autopsy helped to exonerate the accused from being charged with murder. Other medico-legal problems that may be encountered with laryngeal cysts are difficulty in intubation and accidental rupture of a cyst during intubation or otolaryngeal examination.