Related Experiment Videos
Acute apnea caused by an epiglottic cyst
M C Dahm1, B Panning, T Lenarz
1Department of Otorhinolaryngology, Humboldt University of Berlin, Germany. mcdahm@ukrv.de
Insights
A pediatric patient experienced life-threatening apnea during sedation due to an epiglottic retention cyst obstructing the larynx. Surgical removal resolved the obstruction, preventing further respiratory distress.
Area of Science:
- Pediatric Anesthesiology
- Otolaryngology
- Pediatric Emergency Medicine
Background:
- Routine sedation in children can rarely lead to life-threatening airway complications.
- Recurrent stridor and borderline psychomotoric retardation were noted in the patient's history.
- Cerebral MRI was performed for neuroradiological evaluation.
Observation:
- A 5-year-old child developed acute stridor and apnea during routine sedation.
- Emergency orotracheal intubation was required due to the laryngeal obstruction.
- A tumor at the base of the tongue complicated the intubation process.
Findings:
- A large epiglottic retention cyst was identified as the cause of laryngeal obstruction.
- The cyst led to acute apnea, a life-threatening complication.
- Endoscopic removal of the epiglottic cyst was successfully performed.
Implications:
- Prompt diagnosis and endoscopic management of epiglottic cysts are crucial in pediatric airway emergencies.
- This case highlights the importance of thorough airway evaluation in children with recurrent respiratory symptoms.
- Understanding rare causes of airway obstruction can improve patient outcomes during sedation.
Abstract:
A life threatening complication in the course of routine sedation in a 5 year old child is reported in a case study. A retention cyst of the epiglottis was found to be responsible for obstruction of the larynx leading to acute apnea. The patient history revealed recurrent episodes of stridor previously diagnosed and treated as acute laryngotracheobronchitis as well as border line psychomotoric retardation. Cerebral magnetic resonance imaging was performed for neuroradiological evaluation. After administration of sedation the child presented with stridor and acute apnea. Emergency orotracheal intubation could prevent tracheotomy but was complicated by the unexpected presence of a tumor at the base of the tongue. Further evaluation revealed a large epiglottic cyst. After endoscopic removal of the cyst no further episodes of apnea or stridor were noted.