Airway Collapse Due to Unsuspected Epiglottic Cyst

Abstract

Epiglottic cysts are generally benign lesions, which can affect all age groups. Depending on their location and size they can cause airway obstruction and potentially lead to sudden death. We report the case of a 59-year-old female who was admitted to the hospital following respiratory arrest. Her respiratory symptoms developed soon after the administration of a muscle relaxant, which caused the collapse of an existing epiglottic mass into her airway. Prior to the admission to Cleveland Clinic, the patient required resuscitation and emergency cricothyrotomy. The obstruction was confirmed to be an occlusive epiglottic cyst. This was successfully treated with marsupialization. The patient was immediately decanulated without sequelae. INTRODUCTION Epiglottic cysts are abnormalities of the larynx, which have been classified by their location and by their etiology. They are benign tumors whose clinical presentations vary in accordance to their size and exact location. Although epiglottic cysts have been described in all ages, they seem to be more prevalent in the sixth decade. Early diagnosis and treatment will reduce the incidence of airway complications leading to sudden death. Additionally, avoidance of certain substances such as muscle relaxants in patients known to have these lesions will often be necessary; otherwise, collapse of surrounding structures, that would otherwise maintain a patent airway, will be compromised in the unconscious and relaxed patient. doing well. Figure 2 Cup forceps opening the cyst. Figure 1 Bruise on posterior pharyngeal wall Epiglottic Cyst A57