The management of infantile tongue base cyst with laryngomalacia

Abstract

Objective:To explore the diagnosis and therapeutic strategy of laryngomalacia associated with tongue base cyst in infants. Methods:A retrospective analysis was performed on 36 cases of tongue base cyst including 12 cases with concurrent laryngomalacia. Results:All the cysts of the tongue base were completely resected, and no recurrence occurred during the 6-months follow-up. Twelve patients with laryngomalacia were intubated in the ICU after surgery. Tube detachment occurred in one patient in the 1st day after surgery and no reintubation was performed immediately because of stable breathing and the absence of stridor. However, the stridor occurred again in the 5th day after surgery, and revision surgery was performed 1 month after surgery. One patient still had obvious stridor after extubation in the 5th day after sugery, but the shape of glottis was good by laryngoscopy, the stridor was significantly improved at one-month follow-up. One patient died in the 4th day after the operation. The efficiency of surgical treatment in pediatric patients with tongue base cyst and concurrent laryngomalacia was 83.33%. Conclusion:Laryngomalacia combined with tongue base cyst is not uncommon in clinical practice. The symptoms of tongue base cyst may mask those of the underlying laryngomalacia, since their symptoms are highly similar. Simple resection of tongue base cyst may affect the outcome of treatment. Surgeons should further investigate and identify the presence of laryngomalacia after surgical resection of the tongue base cyst and make corresponding management. For type Ⅲ laryngomalacia that cannot be determined intraoperatively, low-temperature plasma ablation of mucosa in the epiglottic valley may be a more minimally invasive option.