A supraglottic laryngeal cyst causing obstructive sleep apnea syndrome

Abstract

Objectives: Cysts in the region of the larynx seldom caused clinical significant symptoms. The adult patients with laryngeal cysts complained primarily of hoarseness, dysphagia, and stridor. However, laryngeal cysts may result in obstructive sleep apnea syndrome. Methods: We report a case of a 47-year-old woman who arrived at our hospital with progressive snoring and daytime sleepness for more than 12 months. Meanwhile, she also suffered from excertional dyspnea, intermittent stridor, and foreign body sensation when swallowing. Her body mass index was 29.6 kg/m2. Indirect mirror and fibroscopic examination revealed a huge pedunculate supraglottic cyst that located on the right aryepiglottic fold. A dynamic magnetic resonance image demonstrated a soft tissue mass with a small pedicle attached to the supraglottic laryngeal wall that obliterated the airway. A preoperative polysomnogram showed mild obstructive sleep apnea syndrome (respiratory disturbance index [RDI] = 13.2 events/hour; snoring index [SI] = 82.6 events/hour). A cystic mass, 2.0 × 1.0 × 1.0 cm 3 in size, was removed by endoscopic carbon dioxide laser surgery. Results: The histological diagnosis was an epithelial cyst. After surgery, a polysomogram revealed a moderate improvement (RDI = 6.7 events/hour; SI = 37.9 events/hour) and she completely recovered from daytime somnolence. Conclusion: A supraglottic cyst in an adult rarely causes obstructive sleep apnea syndrome. Microlaryngoscopic laser surgery is effective in the surgical removal of a supraglottic cyst.