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Acquired subglottic cysts in infancy
S P Smith1, R G Berkowitz, P D Phelan
1Department of Otolaryngology, Royal Children's Hospital, Melbourne, Australia.
Insights
Acquired subglottic cysts in infants, often linked to neonatal intubation, present with stridor. Endoscopic marsupialization is the recommended treatment, showing no recurrences in this study.
Area of Science:
- Pediatric Otolaryngology
- Neonatal Care
Background:
- Acquired subglottic cysts are rare but serious airway obstructions in infants.
- Neonatal intubation is a known risk factor for developing these cysts.
Purpose of the Study:
- To evaluate the clinical presentation and treatment outcomes of infants diagnosed with acquired subglottic cysts.
- To compare the efficacy of different endoscopic treatment modalities.
Main Methods:
- A 12-year retrospective case series at an academic tertiary referral pediatric medical center.
- Eleven infants diagnosed with subglottic cysts were analyzed.
- Treatments included endoscopic cyst rupture or marsupialization using CO2 laser or cup forceps.
Main Results:
- All initial cyst management procedures were successful.
- One symptomatic recurrence occurred after cyst rupture.
- No symptomatic recurrences were observed in patients treated with endoscopic marsupialization (mean follow-up: 6 years).
Conclusions:
- Subglottic cysts should be considered in ex-premature infants with stridor or respiratory difficulty, especially those with a history of neonatal intubation.
- These cysts can develop even after short intubation periods (<24 hours).
- Endoscopic marsupialization is the preferred treatment for acquired subglottic cysts.
Objective:
To evaluate the presentation and treatment of infants with acquired subglottic cysts.
Design:
Case series seen over 12 years.
Setting:
Academic tertiary referral pediatric medical center.
Patients:
Eleven patients had subglottic cysts diagnosed.
Intervention:
Four patients were treated with rupture with the tip of the endoscope. Seven patients underwent endoscopic marsupialization by means of carbon dioxide laser (n = 5) and by cup forceps (n = 2).
Outcome Measures:
Intraoperative cyst control. Symptomatic cyst recurrence.
Results:
Initial cyst management was successful in all cases. There was one symptomatic recurrence in a patient who was managed with cyst rupture. There were no symptomatic recurrences in the group treated by marsupialization. The mean follow-up period was 6 years.
Conclusions:
Subglottic cysts should be considered in the ex-premature infant with a history of neonatal intubation who presents with stridor or respiratory difficulty. These ductal retention cysts can develop after periods of intubation of less than 24 hours. Endoscopic marsupialization is the recommended form of treatment.