Vallecular cyst is a rare entity and accounts for 10. Large vallecular masses are an uncommon disease entity which includes a wide spectrum of rare pathologies. Although rare, vallecular cyst should be included in the differential diagnosis of congenital. The annual incidence of congenital laryngeal cysts varies from 1. The fact that the vallecular cyst is lined with ductal cells squamous or respiratory epithelium rather than with acinar cells lends support to the hypothesis that it is a dilated duct and not a distended gland. Cyst presenting with persistent unexplained cough in a toddler.
Pdf a rare case of vallecular cyst semantic scholar. After excision it was proved a case of vallecular cyst on histopathology. Congenital vallecular cyst causing airway compromise in a 2monthold girl. Histopathology of synovial cysts of the spine chebib. In this report, we discuss the diagnosis and treatment of a patient with an asymptomatic giant vallecular cyst. This report describes the case of a benign lymphoepithelial cyst of the vallecula. Histopathologic findings of both cysts supported the diagnosis and there was no evidence of malignancy. Histopathology showed a benign cyst underneath the. Prompt anticipation of difficult airway is important to reduce morbidity and mortality.
In adults, vallecular cysts are most often asymptomatic and discovered on routine laryngoscopy or during induction of anesthesia. The prevalence of each location varies on different studies. A rare case of vallecular cyst causing neonatal stridor. Vallecular cyst unusual cause of lump in throat sensation. Histology of synovial cysts of the spine shows varied types of cyst. In this study, 20 cases were recovered for the period 19691983. Vallecular cyst is a rare cause of stridor and respiratory distress in infancy and has been associated with sudden airway obstruction resulting in death. The symptoms of a vallecular cyst include but not limited to failure to thrive, voice changes, feeding difficulties, stridor and shortness of breath while in adults the symptoms are commonly mild and the vallecular cyst in the. They are caused by ductal obstruction of minor salivary or mucous glands. Vallecular cyst vc is a life threatening cause of upper respiratory system obstruction, especially in newborns and infants. The otolaryngologist inserted a dedo laryngoscope into the oral cavity.
They consist of a cyst or pseudocyst arising beneath the mucosa of the vallecula, either on the lingual surface of the epiglottis or the base of tongue figure 1 and 2. There are three types of laryngeal cysts, namely, mucous, hemorrhagic and congenital. Bilateral vallecular cysts as a cause of dysphagia. Vallecular cyst vc is a rarely seen but life threatening cause of upper respiratory system obstruction in newborns and infants.
However, when large in size or occur in a small airway like in neonates, it causes respiratory and feeding difficulties. Case report congenital vallecular cyst causing airway compromise in a 2monthold girl amalfaisalalabdulla ent department, bdf hospital, p. Histological or microscopic features of radicular cyst. This showed a mucous cyst in the vallecula that the surgeon marsupialized. Vallecular cysts are rare retention cysts of minor salivary glands seen in the vallecula and base of tongue. The vallecular cyst are lined with mucous glands and with continued mucous secretion, the lesion gradually increases in size. A vallecular cyst is a mucuscontaining cyst in the vallecula.
Other potential causes of cyst include embryological malformation angiomatous, lymphatic malformation. Lump in throat throat fullness, globus syndrome, globus sensation, globus hystericus, globus pharyngeus vallecular cyst. We report a 3 monthsoldmale infant presented with recurrent cough, noisy breathing and regurgitation of feeds since 15 days of life. Typically, there is quite a bit of lymphoid tissue in this location, similar to that found in the tonsils. Discussion vallecular cyst is uncommon laryngeal lesion that accounts only for 10. This is a retrospective cohort study with longitundinal followup. They arise from the obstruction of the submucosal gland ducts and are mainly found in the vallecula.
How to report vallecular cyst marsupialization supercoder. Endoscopic micodebrider assisted marsupalization of. Congenital vallecular cyst causing airway compromise in a. Although rare, vallecular cyst should be included in the differential diagnosis of congenital laryngeal stridor in. A vallecular cyst vc is a rare laryngeal lesion and has the potential to cause significant upper airway obstruction in newborns and infants 1. Vallecular cyst is an uncommon but potentially dangerous condition causing stridor and has been associated with sudden airway obstruction resulting in death due to its anatomical location in neonates. With the expanded scope of oral and maxillofacial surgery, the proper diagnosis and management of vallecular lesions could become a routine part of oral and maxillofacial surgical practice and aid in further development of the specialty. Vallecular cysts are an important differential diagnosis in neonates and. Histologically, the cyst has an external lining of squamous epithelium and may contain respiratory epithelium with. Vallecular cysts have been described in the literature for some time. We describe a case of vallecular cyst with surgical. Laryngeal cysts can occur in any part of the larynx, but are more frequent in supraglottic locations, such as the epiglottis and vallecula. The objective of this study is to discuss the evaluation and treatment of patients with vallecular cysts removed via potassium titanyl phosphate ktp laser therapy.
Histopathology confirmed a cyst lined by thin squamous epithelium consistent in appearance with a vallecular cyst. Congenital vallecular cyst causing airway compromise in a 2. Endoscopic micodebrider assisted marsupalization of vallecula cyst new treatment modality hitesh verma, dr arjun dass, surinder k singha, nitin gupta government medical ollege and hospital, sector 32, handigarh, india abstract ystic lesion of larynx is common entity. We describe the evaluation and treatment of a 70yearold woman who presented with dysphagia caused by large bilateral vallecular cysts. This area of the body is the empty space that is called the vallecula. Histopathology showed squamousepithelial lin ing without thyroid tissue, compatible with vallecular cyst figure 2. Followup of the patient showed no more stridor or respiratory distress, and no recurrence of the cyst. Vallecula cysts vcs arise due to obstruction of the mucous gland duct. The major advantages of histopathology are speed, low cost and the ability to provide a presumptive identification of the infecting fungus as well as demonstrating the tissue reaction. Although congenital vallecular cysts are rare, they should be included in differential diagnosis of stridor and progressive obstruction of the airway in newborns and infants. Vallecular cysts are a form of supraglottic cyst accounting for 10.
A rare case report of vallecular cyst international journal of. Ductal cysts are usually small, approximately 15 mm in diameter. A left vallecular cyst on a sagittal and a coronal view. Airway challenge introduction vallecular cyst is a benign cyst with unknown aetiolgy. Vallecular cysts may present with diverse symptoms affecting the voice, airway, and swallowing. Here we report a rare case of symptomatic vallecular cyst in a neonate. Vallecular cyst, lined by thick squamous epithelium arrow and filled with keratinous debris but without the associated submucosal lymphoid tissue seen in a branchial cyst.
Endoscopic laryngoscopy is necessary to visualize vallecular cyst when suspected clinically. Clinically significant cysts in the region of the larynx are uncommon. Cysts involving the vallecular regions are uncommon lesions and. Pdf on apr 4, 2014, surinder k singhal and others published vallecular cysts in adult population. In literature, different names for the vallecular cyst are recognised and these entail epiglottic cyst, ductal cyst. Vallecular cyst is the name of specific type of cystic fullness in the area between the very back of the tongue base of tongue, and the epiglottis. Case report congenital vallecular cyst causing airway. Original article holmium laser therapy via bronchoscopy. Vallecular cyst is uncommon laryngeal lesion and generally asymptomatic. Histologically, the cyst has an external lining of squamous epithelium and may contain respiratory. The presenting symp toms of congenital vallecular cysts. A vallecular thyroglossal duct cyst presenting with.
A total of 24 patients of vallecular cysts were treated. Vallecular cysts vc including true vallecular cysts and vallecular pseudocysts are rare, but well known causes of upper airway obstruction and death in newborns and infants. From an anatomical point of view, there are laryngeal cysts that develop in close contact with the anterior face of the epiglottis, named true vallecular cysts by some authors and base of tongue cysts sometimes reported as vallecular pseudocysts. Histopathology remains one of the major tools of diagnosis in mycology20 table 3. Histopathology confirmed a cyst lined by thin squamous epithelium. Although rare, vallecular cyst should be included in the differential diagnosis of congenital laryngeal stridor in neonates. Case report vallecular cyst in a 1 month old infant.
These masses may present as purely vallecular in location or appear as an extension from adjacent anatomical sites like tongue base including lingual tonsils, epiglottis, palatine tonsils, epiglottis, and the remainder of supraglottis. Diagnosis and treatment of pediatric vallecular cysts and. Cysts of the vallecula are rare, accounting for 10. As early as the prenatal period, vallecular cysts can be diagnosed by using either ultrasonography or magnetic figure 2 a, b. Full text vallecular cyst case reports international. A vallecular cyst is a rare and a benign entity which is readily diagnosed in newborns and in early childhood and is associated with a high morbidity and mortality. Other cysts in the vallecula will contain only serous fluid. Vallecular cysts are almost always asymptomatic and found during examination for another issue, such as a voice problem. Vallecular cystrevisited, indian journal of pediatrics. The vallecu lar cyst for instance has been named in the literature as mucus retention cyst, epiglottic cyst. However, a new classification system for congenital laryngeal cysts on the basis of the extent of the cyst and the embryologic tissue of origin, is proposed for the ease of initial surgical management. Laryngeal surgery benign disease protocols october 2011 she noted a sensation of a fullness in her throat, more on the left than the right, which has become constant over the last 3.
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