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Lingual cyst in infancy: importance of palpation for diagnosis
K Kaneko1, K Takahashi, A Unno
1Department of Pediatrics, Koshigaya Municipal Hospital, Saitama, Japan.
Insights
Lingual cysts in infants can cause severe breathing issues like stridor. Early oral cavity palpation during physical exams is crucial for diagnosing these potentially life-threatening conditions.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Developmental Biology
Background:
- Lingual cysts are rare congenital or acquired lesions in the oral cavity.
- Infantile stridor is a high-pitched breathing sound indicating airway obstruction, requiring prompt diagnosis.
Observation:
- Two infants presented with severe stridor attributed to lingual cysts.
- Histological examination confirmed one as a salivary retention cyst and the other as a thyroglossal duct cyst.
- Lingual cysts were diagnosed via palpation and non-invasive imaging (ultrasound, CT, MRI).
Findings:
- Lingual cysts, though rare, can cause significant airway compromise in infants, leading to stridor, dyspnea, and even sudden infant death.
- The size of the lingual cyst directly correlated with the severity of respiratory distress.
Implications:
- Routine oral cavity palpation in infants with persistent stridor is essential for early diagnosis of lingual cysts.
- Prompt diagnosis and surgical intervention for lingual cysts can prevent severe respiratory complications and mortality.
- This highlights the importance of integrating non-invasive imaging with physical examination for pediatric airway emergencies.
Abstract:
Two infants, 5 and 12 weeks of age, with lingual cysts were presented. Histological findings were compatible with a salivary retention cyst in one and a thyroglossal duct cyst in the other. Both infants were admitted to our hospital because of severe stridor that had developed from one to two weeks of age. Their lingual cysts were easily recognizable by simple palpation and were confirmed by non-invasive imaging techniques, such as ultrasound sonography, computed tomography and magnetic resonance imaging. Lingual cyst in infancy may be large enough to cause stridor and dyspnea, and occasionally result in sudden infant death, although once diagnosis is made a radical operation can be easily performed. Therefore, it is important that palpation in the oral cavity should be performed with all infants with persistent stridor as a part of a physical examination.