Vallecula-cyste: een zeldzame oorzaak van progressief toenemende inspiratoire stridor bij een neonaat

Abstract

Vallecular cyst: a rare cause of progressive inspiratory stridor in a neonate The medical history of an infant with progressive inspiratory stridor caused by a vallecular cyst is presented. The cyst was diagnosed via a laryngoscopy and treated by means of an excision. The postoperative course was complicated by severe stridor induced by post-intubation edema. This report elaborates on the clinical presentation and work-up. The differential diagnosis of neonatal stridor is exhaustive. A congenital vallecular mass rarely causes it. These masses can manifest in various ways. Symptoms usually develop during the first week(s) of life. Key symptoms are upper airway obstruction and feeding difficulties. Life threatening situations are also possible. Given that the exact etiology of vallecular cysts remains unclear, different hypotheses were proposed. The differential diagnosis should include a dermoid cyst, a thyroglossal duct cyst, a teratoma, an hemangioma or lingual thyroid. The diagnosis usually requires a flexible and/or direct laryngoscopy. Radiographic imaging may also contribute to the work-up, adding information about the anatomical dimensions (for example with regard to the surrounding structures), the exact location, the magnitude, the content, etc. The definitive diagnosis is made through pathological evaluation. Different treatment options are proposed, preferably endoscopic excision or marsupialization.